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

00409490334 LIDOCAINE INJ 20MG/ML 12/31/9999 2012300548339000 LIDOCAINE INJ 20MG/ML 12/31/9999 2012363323020805 LIDOCAINE INJ 20MG/ML 12/31/9999 2012300409428301 LIDOCAINE INJ 4% 12/31/9999 2012300168020437 LIDOCAINE OIN 5% 12/31/9999 2012350383093335 LIDOCAINE OIN 5% 12/31/9999 2012350383093355 LIDOCAINE OIN 5% 12/31/9999 2012351672300803 LIDOCAINE OIN 5% 12/31/9999 2012338779008104 LIDOCAINE POW 12/31/9999 2012338779008105 LIDOCAINE POW 12/31/9999 2012338779008108 LIDOCAINE POW 12/31/9999 2012338779008109 LIDOCAINE POW 12/31/9999 2012338779008203 LIDOCAINE POW HCL 12/31/9999 2012338779008204 LIDOCAINE POW HCL 12/31/9999 2012338779008205 LIDOCAINE POW HCL 12/31/9999 2012338779008208 LIDOCAINE POW HCL 12/31/9999 2012338779008209 LIDOCAINE POW HCL 12/31/9999 2012300054350049 LIDOCAINE SOL 2% VISC 12/31/9999 2012300054850016 LIDOCAINE SOL 2% VISC 12/31/9999 2012300472099633 LIDOCAINE SOL 2% VISC 12/31/9999 2012300603139364 LIDOCAINE SOL 2% VISC 12/31/9999 2012350383077504 LIDOCAINE SOL 2% VISC 12/31/9999 2012360432046400 LIDOCAINE SOL 2% VISC 12/31/9999 2012300054350547 LIDOCAINE SOL 4% 12/31/9999 2012300548630000 LIDOCAINE SOL 4% 12/31/9999 2012300603139447 LIDOCAINE SOL 4% 12/31/9999 2012360432046550 LIDOCAINE SOL 4% 12/31/9999 2012376329630005 LIDOCAINE SOL 4% 12/31/9999 2012300168047914 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012313925015714 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012313925016001 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012313925016003 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012359088081903 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012359088081907 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012359088081914 LIDOCAINE/HC CRE 3%-0.5% 12/31/9999 2012359088081624 LIDOCAINE/HC KIT 2-2% 12/31/9999 2012313925016520 LIDOCAINE/HC KIT 3%-0.5% 12/31/9999 2012359088081920 LIDOCAINE/HC KIT 3%-0.5% 12/31/9999 2012313925016320 LIDOCAINE/HC KIT 3%-1% 12/31/9999 2012359088077120 LIDOCAINE/HC KIT 3%-1% 12/31/9999 2012313925016420 LIDOCAINE/HC KIT 3-2.5% 12/31/9999 2012359088083820 LIDOCAINE/HC KIT 3-2.5% 12/31/9999 2012366870040215 LIDOCREAM CRE 4% 12/31/9999 2012366870040207 LIDOCREAM KIT 4% 12/31/9999 2012363481068706 LIDODERM DIS 5% 12/31/9999 2012359088081701 LIDO-HYDRO GEL 2.8-0.55 12/31/9999 2012300009055501 LINCOCIN INJ 300MG/ML 12/31/9999 2012300009055502 LINCOCIN INJ 300MG/ML 12/31/9999 2012300472057002 LINDANE LOT 1% 12/31/9999 2012300472057016 LINDANE LOT 1% 12/31/9999 2012300472057028 LINDANE LOT 1% 12/31/9999 2012360432083360 LINDANE LOT 1% 12/31/9999 2012361748040102 LINDANE LOT 1% 12/31/9999 2012300472057202 LINDANE SHA 1% 12/31/9999 2012300472057216 LINDANE SHA 1% 12/31/9999 2012300472057228 LINDANE SHA 1% 12/31/9999 2012360432083460 LINDANE SHA 1% 12/31/9999 2012361748040002 LINDANE SHA 1% 12/31/9999 2012358281056201 LIORESAL INT INJ 0.05MG/1 12/31/9999 2012358281056001 LIORESAL INT INJ 10MG/20 12/31/9999 20123