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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43386<strong>01</strong>40<strong>01</strong> METHYLERGON TAB 0.2MG 12/31/9999 2<strong>01</strong>2343386<strong>01</strong>4028 METHYLERGON TAB 0.2MG 12/31/9999 2<strong>01</strong>2359630076210 METHYLIN CHW 10MG 12/31/9999 2<strong>01</strong>2359630076<strong>01</strong>0 METHYLIN CHW 2.5MG 12/31/9999 2<strong>01</strong>2359630076110 METHYLIN CHW 5MG 12/31/9999 2<strong>01</strong>2359630075550 METHYLIN SOL 10MG/5ML 12/31/9999 2<strong>01</strong>2359630075050 METHYLIN SOL 5MG/5ML 12/31/9999 2<strong>01</strong>23004061122<strong>01</strong> METHYLIN TAB 10MG 12/31/9999 2<strong>01</strong>2300406112210 METHYLIN TAB 10MG 12/31/9999 2<strong>01</strong>23004061423<strong>01</strong> METHYLIN TAB 10MG ER 12/31/9999 2<strong>01</strong>23004061124<strong>01</strong> METHYLIN TAB 20MG 12/31/9999 2<strong>01</strong>2300406112410 METHYLIN TAB 20MG 12/31/9999 2<strong>01</strong>23004061451<strong>01</strong> METHYLIN TAB 20MG ER 12/31/9999 2<strong>01</strong>23004061121<strong>01</strong> METHYLIN TAB 5MG 12/31/9999 2<strong>01</strong>2300406112110 METHYLIN TAB 5MG 12/31/9999 2<strong>01</strong>23000935295<strong>01</strong> METHYLPHENID CAP 10MG 12/31/9999 2<strong>01</strong>2362175<strong>01</strong>5137 METHYLPHENID CAP 10MG 12/31/9999 2<strong>01</strong>23000935296<strong>01</strong> METHYLPHENID CAP 20MG 12/31/9999 2<strong>01</strong>2362175<strong>01</strong>5237 METHYLPHENID CAP 20MG 12/31/9999 2<strong>01</strong>23000935346<strong>01</strong> METHYLPHENID CAP 20MG ER 12/31/9999 2<strong>01</strong>23677670200<strong>01</strong> METHYLPHENID CAP 20MG ER 12/31/9999 2<strong>01</strong>23000935297<strong>01</strong> METHYLPHENID CAP 30MG 12/31/9999 2<strong>01</strong>2362175<strong>01</strong>5337 METHYLPHENID CAP 30MG 12/31/9999 2<strong>01</strong>23000935347<strong>01</strong> METHYLPHENID CAP 30MG ER 12/31/9999 2<strong>01</strong>236776702<strong>01</strong><strong>01</strong> METHYLPHENID CAP 30MG ER 12/31/9999 2<strong>01</strong>23000935298<strong>01</strong> METHYLPHENID CAP 40MG 12/31/9999 2<strong>01</strong>2362175<strong>01</strong>5437 METHYLPHENID CAP 40MG 12/31/9999 2<strong>01</strong>23000935348<strong>01</strong> METHYLPHENID CAP 40MG ER 12/31/9999 2<strong>01</strong>23677670202<strong>01</strong> METHYLPHENID CAP 40MG ER 12/31/9999 2<strong>01</strong>23000935292<strong>01</strong> METHYLPHENID CAP 50MG 12/31/9999 2<strong>01</strong>2362175<strong>01</strong>5537 METHYLPHENID CAP 50MG 12/31/9999 2<strong>01</strong>23000935293<strong>01</strong> METHYLPHENID CAP 60MG 12/31/9999 2<strong>01</strong>2362175<strong>01</strong>5637 METHYLPHENID CAP 60MG 12/31/9999 2<strong>01</strong>2351991071350 METHYLPHENID SOL 10MG/5ML 12/31/9999 2<strong>01</strong>2351991071250 METHYLPHENID SOL 5MG/5ML 12/31/9999 2<strong>01</strong>23004061144<strong>01</strong> METHYLPHENID TAB 10MG 12/31/9999 2<strong>01</strong>2300406114410 METHYLPHENID TAB 10MG 12/31/9999 2<strong>01</strong>23005915883<strong>01</strong> METHYLPHENID TAB 10MG 12/31/9999 2<strong>01</strong>23007815749<strong>01</strong> METHYLPHENID TAB 10MG 12/31/9999 2<strong>01</strong>2353<strong>01</strong>4053007 METHYLPHENID TAB 10MG 12/31/9999 2<strong>01</strong>23004061445<strong>01</strong> METHYLPHENID TAB 10MG ER 12/31/9999 2<strong>01</strong>23005912715<strong>01</strong> METHYLPHENID TAB 18MG ER 12/31/9999 2<strong>01</strong>23004061146<strong>01</strong> METHYLPHENID TAB 20MG 12/31/9999 2<strong>01</strong>2300406114610 METHYLPHENID TAB 20MG 12/31/9999 2<strong>01</strong>23005915884<strong>01</strong> METHYLPHENID TAB 20MG 12/31/9999 2<strong>01</strong>23007815753<strong>01</strong> METHYLPHENID TAB 20MG 12/31/9999 2<strong>01</strong>2353<strong>01</strong>4053207 METHYLPHENID TAB 20MG 12/31/9999 2<strong>01</strong>23004061473<strong>01</strong> METHYLPHENID TAB 20MG ER 12/31/9999 2<strong>01</strong>23007815754<strong>01</strong> METHYLPHENID TAB 20MG SR 12/31/9999 2<strong>01</strong>23005912716<strong>01</strong> METHYLPHENID TAB 27MG ER 12/31/9999 2<strong>01</strong>23005912717<strong>01</strong> METHYLPHENID TAB 36MG ER 12/31/9999 2<strong>01</strong>23005912718<strong>01</strong> METHYLPHENID TAB 54MG ER 12/31/9999 2<strong>01</strong>23004061142<strong>01</strong> METHYLPHENID TAB 5MG 12/31/9999 2<strong>01</strong>2300406114210 METHYLPHENID TAB 5MG 12/31/9999 2<strong>01</strong>23005915882<strong>01</strong> METHYLPHENID TAB 5MG 12/31/9999 2<strong>01</strong>23007815748<strong>01</strong> METHYLPHENID TAB 5MG 12/31/9999 2<strong>01</strong>2353<strong>01</strong>4053107 METHYLPHENID TAB 5MG 12/31/9999 2<strong>01</strong>23007030031<strong>01</strong> METHYLPR ACE INJ 40MG/ML 12/31/9999 2<strong>01</strong>2300703003104 METHYLPR ACE INJ 40MG/ML 12/31/9999 2<strong>01</strong>23007030043<strong>01</strong> METHYLPR ACE INJ 40MG/ML 12/31/9999 2<strong>01</strong>23

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