Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...
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Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...

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0<strong>01</strong>43312505 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>23003780810<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300378081005 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300378081093 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>23005271635<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>23005910347<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300591034705 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300603385521 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300603385525 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300603385532 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300603385593 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>23231550045<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2323155004505 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>30<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>3005 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>3<strong>01</strong>0 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>23510790776<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2351079077620 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2359746038206 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2359746038210 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2359762173502 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>13<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>1399 HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>23680840398<strong>01</strong> HYDROCHLOROT CAP 12.5MG 12/31/9999 2<strong>01</strong>2300228282<strong>01</strong>1 HYDROCHLOROT TAB 12.5MG 12/31/9999 2<strong>01</strong>2323155<strong>01</strong>37<strong>01</strong> HYDROCHLOROT TAB 12.5MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>431256<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43125610 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43125625 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43125651 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>72208300 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>72208310 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>72208360 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>72208380 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>23005271413<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2300527141310 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2300603385621 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2300603385632 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2300603385634 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>23231550047<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2323155004710 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>28<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>2810 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2354458093<strong>01</strong>0 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2354458093910 HYDROCHLOROT TAB 25MG 11/<strong>01</strong>/2<strong>01</strong>3 2<strong>01</strong>2354458094110 HYDROCHLOROT TAB 25MG 03/<strong>01</strong>/2<strong>01</strong>3 2<strong>01</strong>2359746<strong>01</strong>2510 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2359762173602 HYDROCHLOROT TAB 25MG 02/28/2<strong>01</strong>3 2<strong>01</strong>2359762173607 HYDROCHLOROT TAB 25MG 02/28/2<strong>01</strong>3 2<strong>01</strong>23605052640<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2360505264007 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2360505264008 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2363739<strong>01</strong>2810 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2364125<strong>01</strong>31<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2364125<strong>01</strong>3110 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>33<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>3399 HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>23680840086<strong>01</strong> HYDROCHLOROT TAB 25MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>431257<strong>01</strong> HYDROCHLOROT TAB 50MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43125710 HYDROCHLOROT TAB 50MG 12/31/9999 2<strong>01</strong>23

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