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

46122010952 LORATADINE-D TAB 5-120MG 12/31/9999 2012300054353244 LORAZEPAM CON 2MG/ML 12/31/9999 2012300121077001 LORAZEPAM CON 2MG/ML 12/31/9999 2012300574016330 LORAZEPAM CON 2MG/ML 12/31/9999 2012350383070530 LORAZEPAM CON 2MG/ML 12/31/9999 2012365162068784 LORAZEPAM CON 2MG/ML 12/31/9999 2012300409198530 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300409677802 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300409678002 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641604401 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641604425 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641604601 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641604610 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641604801 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641604825 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641605001 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300641605010 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010201 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010210 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010237 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010239 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010501 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010502 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010544 LORAZEPAM INJ 2MG/ML 12/31/9999 2012310019010571 LORAZEPAM INJ 2MG/ML 12/31/9999 2012317478004001 LORAZEPAM INJ 2MG/ML 12/31/9999 2012300409153931 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300409677902 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300409678102 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641604501 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641604525 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641604701 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641604710 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641604901 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641604925 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641605101 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300641605110 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010301 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010310 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010337 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010339 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010601 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010602 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010644 LORAZEPAM INJ 4MG/ML 12/31/9999 2012310019010671 LORAZEPAM INJ 4MG/ML 12/31/9999 2012300228205710 LORAZEPAM TAB 0.5MG 12/31/9999 2012300228205750 LORAZEPAM TAB 0.5MG 12/31/9999 2012300378232101 LORAZEPAM TAB 0.5MG 12/31/9999 2012300378232105 LORAZEPAM TAB 0.5MG 12/31/9999 2012300591024001 LORAZEPAM TAB 0.5MG 12/31/9999 2012300591024005 LORAZEPAM TAB 0.5MG 12/31/9999 2012300591024010 LORAZEPAM TAB 0.5MG 12/31/9999 2012300904150061 LORAZEPAM TAB 0.5MG 12/31/9999 2012300904150080 LORAZEPAM TAB 0.5MG 12/31/9999 2012300904598061 LORAZEPAM TAB 0.5MG 12/31/9999 2012300904600740 LORAZEPAM TAB 0.5MG 12/31/9999 2012300904600760 LORAZEPAM TAB 0.5MG 12/31/9999 2012351079041701 LORAZEPAM TAB 0.5MG 12/31/9999 2012351079041720 LORAZEPAM TAB 0.5MG 12/31/9999 2012351079041721 LORAZEPAM TAB 0.5MG 12/31/9999 20123