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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00409230662 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2300641605710 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2300641605725 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>90028<strong>01</strong> MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002804 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002859 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2325021065502 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>3702 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2357664063343 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2363323041112 MIDAZOLAM INJ 2MG/2ML 12/31/9999 2<strong>01</strong>2300409259605 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>23006416060<strong>01</strong> MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2300641606<strong>01</strong>0 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002710 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002739 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2325021066110 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>2610 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2357664063445 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2363323041210 MIDAZOLAM INJ 50MG/10 12/31/9999 2<strong>01</strong>2300409230505 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2300409230550 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>23006416059<strong>01</strong> MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2300641605910 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002805 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002837 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2325021065505 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>3705 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2363323041125 MIDAZOLAM INJ 5MG/5ML 12/31/9999 2<strong>01</strong>2300409230760 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>23004092308<strong>01</strong> MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300409230849 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300409259603 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300409259652 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300409259653 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300641606110 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300641606125 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002706 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002709 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9002764 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>23250210656<strong>01</strong> MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>38<strong>01</strong> MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2363323041225 MIDAZOLAM INJ 5MG/ML 12/31/9999 2<strong>01</strong>2300054356699 MIDAZOLAM SYP 2MG/ML 12/31/9999 2<strong>01</strong>2300574<strong>01</strong>5004 MIDAZOLAM SYP 2MG/ML 12/31/9999 2<strong>01</strong>2363304020518 MIDAZOLAM SYP 2MG/ML 12/31/9999 2<strong>01</strong>2368094071659 MIDAZOLAM SYP 2MG/ML 12/31/9999 2<strong>01</strong>2368094071662 MIDAZOLAM SYP 2MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>154233<strong>01</strong> MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>85<strong>01</strong>49<strong>01</strong> MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>2300245021311 MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>23003781903<strong>01</strong> MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>2350268056615 MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>23605051325<strong>01</strong> MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>2360505132508 MIDODRINE TAB 10MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>154211<strong>01</strong> MIDODRINE TAB 2.5MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>850040<strong>01</strong> MIDODRINE TAB 2.5MG 12/31/9999 2<strong>01</strong>2300245021111 MIDODRINE TAB 2.5MG 12/31/9999 2<strong>01</strong>230037819<strong>01</strong><strong>01</strong> MIDODRINE TAB 2.5MG 12/31/9999 2<strong>01</strong>2350268056415 MIDODRINE TAB 2.5MG 12/31/9999 2<strong>01</strong>23605051320<strong>01</strong> MIDODRINE TAB 2.5MG 12/31/9999 2<strong>01</strong>23

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