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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54458096405 MELOXICAM TAB 15MG 04/<strong>01</strong>/2<strong>01</strong>3 2<strong>01</strong>2354458096410 MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>23605052554<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2360505255408 MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>23605053579<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>27<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>2710 MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>23658620098<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>23681800502<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2368180050202 MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2368180050203 MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>23683820051<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2368382005105 MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>2368462<strong>01</strong>41<strong>01</strong> MELOXICAM TAB 15MG 12/31/9999 2<strong>01</strong>23000937234<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>23003781066<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2300378106605 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>24<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2329300<strong>01</strong>2410 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>23510790457<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2351079045720 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2354458096510 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>23605052553<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2360505255308 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>23605053578<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>26<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2361442<strong>01</strong>2610 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>23658620097<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>236818005<strong>01</strong><strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>236818005<strong>01</strong>02 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>236818005<strong>01</strong>03 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>23683820050<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2368382005005 MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2368462<strong>01</strong>40<strong>01</strong> MELOXICAM TAB 7.5MG 12/31/9999 2<strong>01</strong>2358980047305 MELPAQUE HP CRE 4% 12/31/9999 2<strong>01</strong>2358980047310 MELPAQUE HP CRE 4% 12/31/9999 2<strong>01</strong>2367457<strong>01</strong>95<strong>01</strong> MELPHALAN INJ 50MG 12/31/9999 2<strong>01</strong>23674570215<strong>01</strong> MELPHALAN INJ 50MG 12/31/9999 2<strong>01</strong>2358980047610 MELQUIN 3 SOL 3% 12/31/9999 2<strong>01</strong>2358980047205 MELQUIN HP CRE 4% 12/31/9999 2<strong>01</strong>2358980047210 MELQUIN HP CRE 4% 12/31/9999 2<strong>01</strong>2312830081<strong>01</strong>6 M-END DM LIQ 12/31/9999 2<strong>01</strong>2312830081616 M-END DMX LIQ 12/31/9999 2<strong>01</strong>2312830073916 M-END MAX D LIQ 12/31/9999 2<strong>01</strong>2312830075412 M-END PE LIQ 12/31/9999 2<strong>01</strong>2312830073516 M-END WC LIQ 12/31/9999 2<strong>01</strong>23615700072<strong>01</strong> MENEST TAB 0.3MG 12/31/9999 2<strong>01</strong>23615700073<strong>01</strong> MENEST TAB 0.625MG 12/31/9999 2<strong>01</strong>23615700074<strong>01</strong> MENEST TAB 1.25MG 12/31/9999 2<strong>01</strong>2361570007550 MENEST TAB 2.5MG 12/31/9999 2<strong>01</strong>235556675<strong>01</strong>02 MENOPUR INJ 75UNIT 12/31/9999 2<strong>01</strong>2350419045504 MENOSTAR DIS 14MCG 12/31/9999 2<strong>01</strong>2300904575360 MENSTRUAL TAB COMPLETE 12/31/9999 2<strong>01</strong>2337205033962 MENSTRUAL TAB MAX ST 12/31/9999 2<strong>01</strong>2300378615146 MENTAX CRE 1% 12/31/9999 2<strong>01</strong>2300378615149 MENTAX CRE 1% 12/31/9999 2<strong>01</strong>23006416054<strong>01</strong> MEPERIDINE INJ 100MG/ML 12/31/9999 2<strong>01</strong>2300641605425 MEPERIDINE INJ 100MG/ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9<strong>01</strong>62<strong>01</strong> MEPERIDINE INJ 100MG/ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9<strong>01</strong>6244 MEPERIDINE INJ 100MG/ML 12/31/9999 2<strong>01</strong>23

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