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

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

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

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38779098908 AMINOCAPROIC POW ACID 12/31/9999 2<strong>01</strong>2300006339511 AMINOHIPPURA INJ 20% 12/31/9999 2<strong>01</strong>23004095921<strong>01</strong> AMINOPHYLLIN INJ 25MG/ML 12/31/9999 2<strong>01</strong>23004095922<strong>01</strong> AMINOPHYLLIN INJ 25MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>431020<strong>01</strong> AMINOPHYLLIN TAB 100MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43102<strong>01</strong>0 AMINOPHYLLIN TAB 100MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>431025<strong>01</strong> AMINOPHYLLIN TAB 200MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43102510 AMINOPHYLLIN TAB 200MG 12/31/9999 2<strong>01</strong>2300409419103 AMINOSYN INJ 10% 12/31/9999 2<strong>01</strong>2300409419105 AMINOSYN INJ 10% 12/31/9999 2<strong>01</strong>2300409418703 AMINOSYN INJ 8.5% 12/31/9999 2<strong>01</strong>2300409420303 AMINOSYN INJ 8.5/LYTE 12/31/9999 2<strong>01</strong>2300409416403 AMINOSYN II INJ 10% 12/31/9999 2<strong>01</strong>2300409416405 AMINOSYN II INJ 10% 12/31/9999 2<strong>01</strong>2300409712107 AMINOSYN II INJ 10% 12/31/9999 2<strong>01</strong>2300409717217 AMINOSYN II INJ 10% 12/31/9999 2<strong>01</strong>2300409717117 AMINOSYN II INJ 15% 12/31/9999 2<strong>01</strong>2300409416203 AMINOSYN II INJ 8.5% 12/31/9999 2<strong>01</strong>2300409417103 AMINOSYN II INJ 8.5/LYTE 12/31/9999 2<strong>01</strong>2300409419605 AMINOSYN M INJ 3.5% 12/31/9999 2<strong>01</strong>2300409416803 AMINOSYN-HBC INJ 7% 12/31/9999 2<strong>01</strong>2300409417905 AMINOSYN-PF INJ 10% 12/31/9999 2<strong>01</strong>2300409417803 AMINOSYN-PF INJ 7% 12/31/9999 2<strong>01</strong>2300409416603 AMINOSYN-RF INJ 5.2% 12/31/9999 2<strong>01</strong>230<strong>01</strong>43987510 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2300409434835 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2300409434849 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2300548338000 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2363323061603 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2363323061609 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2367457<strong>01</strong>5303 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2367457<strong>01</strong>5309 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2367457<strong>01</strong>5318 AMIODARONE INJ 50MG/ML 12/31/9999 2<strong>01</strong>2300093913306 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2300093913352 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>4405 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>4409 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>4460 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2313107005605 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2313107005660 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>23510790906<strong>01</strong> AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2351079090617 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2351079090619 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2351079090620 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2351672402504 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2363739038710 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>23680840371<strong>01</strong> AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2368382022705 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2368382022714 AMIODARONE TAB 200MG 12/31/9999 2<strong>01</strong>2351672405700 AMIODARONE TAB 400MG 12/31/9999 2<strong>01</strong>2351672405706 AMIODARONE TAB 400MG 12/31/9999 2<strong>01</strong>2364764024060 AMITIZA CAP 24MCG 12/31/9999 2<strong>01</strong>2364764008060 AMITIZA CAP 8MCG 12/31/9999 2<strong>01</strong>2338779<strong>01</strong>8903 AMITRIPTYLIN POW HCL 12/31/9999 2<strong>01</strong>2338779<strong>01</strong>8904 AMITRIPTYLIN POW HCL 12/31/9999 2<strong>01</strong>2338779<strong>01</strong>8905 AMITRIPTYLIN POW HCL 12/31/9999 2<strong>01</strong>2338779<strong>01</strong>8908 AMITRIPTYLIN POW HCL 12/31/9999 2<strong>01</strong>2338779<strong>01</strong>8909 AMITRIPTYLIN POW HCL 12/31/9999 2<strong>01</strong>23003782685<strong>01</strong> AMITRIPTYLIN TAB 100MG 12/31/9999 2<strong>01</strong>2300378268593 AMITRIPTYLIN TAB 100MG 12/31/9999 2<strong>01</strong>23

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