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

00409379301 KETOROLAC INJ 15MG/ML 12/31/9999 2012300409379349 KETOROLAC INJ 15MG/ML 12/31/9999 2012310019002902 KETOROLAC INJ 15MG/ML 12/31/9999 2012310019002912 KETOROLAC INJ 15MG/ML 12/31/9999 2012355390048001 KETOROLAC INJ 15MG/ML 12/31/9999 2012363323016101 KETOROLAC INJ 15MG/ML 12/31/9999 2012364679075701 KETOROLAC INJ 15MG/ML 12/31/9999 2012364679075702 KETOROLAC INJ 15MG/ML 12/31/9999 2012300409228731 KETOROLAC INJ 30MG/ML 12/31/9999 2012300409379501 KETOROLAC INJ 30MG/ML 12/31/9999 2012300409379549 KETOROLAC INJ 30MG/ML 12/31/9999 2012310019003003 KETOROLAC INJ 30MG/ML 12/31/9999 2012310019003012 KETOROLAC INJ 30MG/ML 12/31/9999 2012355390048101 KETOROLAC INJ 30MG/ML 12/31/9999 2012355390048110 KETOROLAC INJ 30MG/ML 12/31/9999 2012363323016201 KETOROLAC INJ 30MG/ML 12/31/9999 2012364679075801 KETOROLAC INJ 30MG/ML 12/31/9999 2012364679075804 KETOROLAC INJ 30MG/ML 12/31/9999 2012300409228761 KETOROLAC INJ 60MG/2ML 12/31/9999 2012300409379601 KETOROLAC INJ 60MG/2ML 12/31/9999 2012300409379649 KETOROLAC INJ 60MG/2ML 12/31/9999 2012310019003004 KETOROLAC INJ 60MG/2ML 12/31/9999 2012310019003017 KETOROLAC INJ 60MG/2ML 12/31/9999 2012355390048102 KETOROLAC INJ 60MG/2ML 12/31/9999 2012363323016202 KETOROLAC INJ 60MG/2ML 12/31/9999 2012364679075802 KETOROLAC INJ 60MG/2ML 12/31/9999 2012364679075806 KETOROLAC INJ 60MG/2ML 12/31/9999 2012317478020810 KETOROLAC SOL 0.4% 12/31/9999 2012360505057001 KETOROLAC SOL 0.4% 12/31/9999 2012361314001805 KETOROLAC SOL 0.4% 12/31/9999 2012317478020910 KETOROLAC SOL 0.5% 12/31/9999 2012317478020911 KETOROLAC SOL 0.5% 12/31/9999 2012317478020919 KETOROLAC SOL 0.5% 12/31/9999 2012341616021990 KETOROLAC SOL 0.5% 12/31/9999 2012341616022090 KETOROLAC SOL 0.5% 12/31/9999 2012341616022190 KETOROLAC SOL 0.5% 12/31/9999 2012360505100301 KETOROLAC SOL 0.5% 12/31/9999 2012360505100302 KETOROLAC SOL 0.5% 12/31/9999 2012361314012605 KETOROLAC SOL 0.5% 12/31/9999 2012361314012610 KETOROLAC SOL 0.5% 12/31/9999 2012300093031401 KETOROLAC TAB 10MG 12/31/9999 2012300378113401 KETOROLAC TAB 10MG 12/31/9999 2012317478071710 KETOTIF FUM DRO 0.025%OP 12/31/9999 2012300536231097 KIDKARE LIQ CGH/COLD 12/31/9999 2012366658023407 KINERET INJ 12/31/9999 2012366658023428 KINERET INJ 12/31/9999 2012300574200416 KIONEX POW USP 12/31/9999 2012300574200202 KIONEX SUS 15GM/60 12/31/9999 2012300574200216 KIONEX SUS 15GM/60 12/31/9999 2012300066750004 KLARON LOT 10% 12/31/9999 2012300004006801 KLONOPIN TAB 0.5MG 12/31/9999 2012300004006832 KLONOPIN TAB 0.5MG 12/31/9999 2012300004005801 KLONOPIN TAB 1MG 12/31/9999 2012300004005832 KLONOPIN TAB 1MG 12/31/9999 2012300004009801 KLONOPIN TAB 2MG 12/31/9999 2012300245003501 KLOR-CON POW 20MEQ 12/31/9999 2012300245003530 KLOR-CON POW 20MEQ 12/31/9999 2012300245004100 KLOR-CON 10 TAB 10MEQ ER 12/31/9999 2012300245004101 KLOR-CON 10 TAB 10MEQ ER 12/31/9999 2012300245004111 KLOR-CON 10 TAB 10MEQ ER 12/31/9999 20123