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 ...

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59746<strong>01</strong>2210 MECLIZINE TAB 12.5MG 12/31/9999 2<strong>01</strong>2365162044110 MECLIZINE TAB 12.5MG 12/31/9999 2<strong>01</strong>2365162044111 MECLIZINE TAB 12.5MG 12/31/9999 2<strong>01</strong>2365162044150 MECLIZINE TAB 12.5MG 12/31/9999 2<strong>01</strong>23680840490<strong>01</strong> MECLIZINE TAB 12.5MG 12/31/9999 2<strong>01</strong>2300378548610 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2300378548677 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>23007811375<strong>01</strong> MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>23498840035<strong>01</strong> MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2349884003510 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>23510790090<strong>01</strong> MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2351079009020 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2359746<strong>01</strong>2106 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2359746<strong>01</strong>2110 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2365162044210 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2365162044211 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>2365162044250 MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>23680840491<strong>01</strong> MECLIZINE TAB 25MG 12/31/9999 2<strong>01</strong>23003783000<strong>01</strong> MECLOFEN SOD CAP 100MG 12/31/9999 2<strong>01</strong>2300378300005 MECLOFEN SOD CAP 100MG 12/31/9999 2<strong>01</strong>23003782150<strong>01</strong> MECLOFEN SOD CAP 50MG 12/31/9999 2<strong>01</strong>2336800<strong>01</strong>1036 MED DOUCHE SOL 0.3% 12/31/9999 2<strong>01</strong>2300904505960 MEDI PAD 12/31/9999 2<strong>01</strong>2300904509877 MEDICATED POW BODY 12/31/9999 2<strong>01</strong>2349614040410 MEDI-CORT CRE 1% 12/31/9999 2<strong>01</strong>2363868099850 MEDIFIN 400 TAB 400MG 12/31/9999 2<strong>01</strong>2363868075250 MEDIFIN PE TAB 10-400MG 12/31/9999 2<strong>01</strong>2338779225808 MEDIHOL BASE GEL 12/31/9999 2<strong>01</strong>2349614046262 MEDI-PHEDRYL CAP 25MG 12/31/9999 2<strong>01</strong>2349614046278 MEDI-PHEDRYL CAP 25MG 12/31/9999 2<strong>01</strong>2349614<strong>01</strong>5358 MEDI-PROFEN CAP 200MG 12/31/9999 2<strong>01</strong>2300009005604 MEDROL PAK 4MG 12/31/9999 2<strong>01</strong>23000090073<strong>01</strong> MEDROL TAB 16MG 12/31/9999 2<strong>01</strong>2300009004902 MEDROL TAB 2MG 12/31/9999 2<strong>01</strong>2300009<strong>01</strong>76<strong>01</strong> MEDROL TAB 32MG 12/31/9999 2<strong>01</strong>2300009005602 MEDROL TAB 4MG 12/31/9999 2<strong>01</strong>23000090022<strong>01</strong> MEDROL TAB 8MG 12/31/9999 2<strong>01</strong>230070368<strong>01</strong><strong>01</strong> MEDROXYPR AC INJ 150MG/ML 12/31/9999 2<strong>01</strong>230070368<strong>01</strong>04 MEDROXYPR AC INJ 150MG/ML 12/31/9999 2<strong>01</strong>23597624537<strong>01</strong> MEDROXYPR AC INJ 150MG/ML 12/31/9999 2<strong>01</strong>2359762453702 MEDROXYPR AC INJ 150MG/ML 12/31/9999 2<strong>01</strong>23597624538<strong>01</strong> MEDROXYPR AC INJ 150MG/ML 11/30/2<strong>01</strong>3 2<strong>01</strong>2359762453802 MEDROXYPR AC INJ 150MG/ML 12/31/9999 2<strong>01</strong>2359762453809 MEDROXYPR AC INJ 150MG/ML 12/31/9999 2<strong>01</strong>2300555077902 MEDROXYPR AC TAB 10MG 12/31/9999 2<strong>01</strong>2300555077904 MEDROXYPR AC TAB 10MG 12/31/9999 2<strong>01</strong>2359762374202 MEDROXYPR AC TAB 10MG 12/31/9999 2<strong>01</strong>2359762374208 MEDROXYPR AC TAB 10MG 12/31/9999 2<strong>01</strong>2300555087202 MEDROXYPR AC TAB 2.5MG 12/31/9999 2<strong>01</strong>2300555087204 MEDROXYPR AC TAB 2.5MG 12/31/9999 2<strong>01</strong>23597623740<strong>01</strong> MEDROXYPR AC TAB 2.5MG 12/31/9999 2<strong>01</strong>2359762374005 MEDROXYPR AC TAB 2.5MG 12/31/9999 2<strong>01</strong>2368084055321 MEDROXYPR AC TAB 2.5MG 12/31/9999 2<strong>01</strong>2300555087302 MEDROXYPR AC TAB 5MG 12/31/9999 2<strong>01</strong>2300555087304 MEDROXYPR AC TAB 5MG 12/31/9999 2<strong>01</strong>23597623741<strong>01</strong> MEDROXYPR AC TAB 5MG 12/31/9999 2<strong>01</strong>2359762374104 MEDROXYPR AC TAB 5MG 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>95<strong>01</strong> MEFENAM ACID CAP 250MG 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>9530 MEFENAM ACID CAP 250MG 12/31/9999 2<strong>01</strong>2366993007030 MEFENAM ACID CAP 250MG 12/31/9999 2<strong>01</strong>23

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