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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00067617185 LAMISIL AT CRE 1% 12/31/9999 2<strong>01</strong>2300067629543 LAMISIL AT CRE 1% 12/31/9999 2<strong>01</strong>23000674000<strong>01</strong> LAMISIL AT SPR 12/31/9999 2<strong>01</strong>230006740<strong>01</strong><strong>01</strong> LAMISIL AT SPR 12/31/9999 2<strong>01</strong>230006740<strong>01</strong>30 LAMISIL AT SPR 12/31/9999 2<strong>01</strong>2300067629283 LAMISIL AT SPR 1% 12/31/9999 2<strong>01</strong>2300067629383 LAMISIL AT SPR 1% 12/31/9999 2<strong>01</strong>2300093538506 LAMIVUD/ZIDO TAB 150-300 12/31/9999 2<strong>01</strong>2365862059760 LAMIVUD/ZIDO TAB 150-300 12/31/9999 2<strong>01</strong>2368180028407 LAMIVUD/ZIDO TAB 150-300 12/31/9999 2<strong>01</strong>2360505325106 LAMIVUDINE TAB 150MG 12/31/9999 2<strong>01</strong>2365862055260 LAMIVUDINE TAB 150MG 12/31/9999 2<strong>01</strong>2368084057821 LAMIVUDINE TAB 150MG 12/31/9999 2<strong>01</strong>2360505325203 LAMIVUDINE TAB 300MG 12/31/9999 2<strong>01</strong>2365862055330 LAMIVUDINE TAB 300MG 12/31/9999 2<strong>01</strong>2300093<strong>01</strong>32<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23003786925<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23162520598<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23516724140<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23551110226<strong>01</strong> LAMOTRIGINE CHW 25MG 04/30/2<strong>01</strong>3 2<strong>01</strong>2355111022605 LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23658620362<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>2368084033521 LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>2368382<strong>01</strong>09<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23684620229<strong>01</strong> LAMOTRIGINE CHW 25MG 12/31/9999 2<strong>01</strong>23000930688<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>23003786905<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>23162520597<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>23516724139<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>23551110225<strong>01</strong> LAMOTRIGINE CHW 5MG 04/30/2<strong>01</strong>3 2<strong>01</strong>23658620361<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>2368382<strong>01</strong>08<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>23684620228<strong>01</strong> LAMOTRIGINE CHW 5MG 12/31/9999 2<strong>01</strong>2313668004529 LAMOTRIGINE KIT START 35 12/31/9999 2<strong>01</strong>2313668026699 LAMOTRIGINE KIT START 49 12/31/9999 2<strong>01</strong>2313668026628 LAMOTRIGINE KIT START 98 12/31/9999 2<strong>01</strong>23000930463<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2300093046305 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2300093046319 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2300093046393 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23003784252<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2300378425205 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23136680047<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2313668004705 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2313668004730 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2313668004774 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2316714037202 LAMOTRIGINE TAB 100MG 12/31/2020 2<strong>01</strong>23510790499<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2351079049920 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23516724131<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2351672413103 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23551110221<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2355111022105 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23597460246<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2359746024610 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23605052664<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2360505266405 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>2363739051610 LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23658620228<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23680840319<strong>01</strong> LAMOTRIGINE TAB 100MG 12/31/9999 2<strong>01</strong>23

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