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

60505132008 MIDODRINE TAB 2.5MG 12/31/9999 2012368084024001 MIDODRINE TAB 2.5MG 12/31/9999 2012300115422201 MIDODRINE TAB 5MG 12/31/9999 2012300185004301 MIDODRINE TAB 5MG 12/31/9999 2012300185004305 MIDODRINE TAB 5MG 12/31/9999 2012300245021201 MIDODRINE TAB 5MG 12/31/9999 2012300245021211 MIDODRINE TAB 5MG 12/31/9999 2012300378190201 MIDODRINE TAB 5MG 12/31/9999 2012350268056515 MIDODRINE TAB 5MG 12/31/9999 2012351079045301 MIDODRINE TAB 5MG 12/31/9999 2012351079045320 MIDODRINE TAB 5MG 12/31/9999 2012360505132101 MIDODRINE TAB 5MG 12/31/9999 2012360505132108 MIDODRINE TAB 5MG 12/31/9999 2012368084024101 MIDODRINE TAB 5MG 12/31/9999 2012364875000103 MIFEPREX TAB 200MG 12/31/9999 2012300713016612 MIGERGOT SUP 2/100 12/31/9999 2012300113037462 MIGRAINE TAB FORMULA 12/31/9999 2012300113037478 MIGRAINE TAB FORMULA 12/31/9999 2012336800037462 MIGRAINE TAB FORMULA 12/31/9999 2012336800037478 MIGRAINE TAB FORMULA 12/31/9999 2012337205028062 MIGRAINE TAB FORMULA 12/31/9999 2012337205028078 MIGRAINE TAB FORMULA 12/31/9999 2012300187024503 MIGRANAL SPR 4MG/ML 12/31/9999 2012300904762260 MIGRATINE CAP 12/31/9999 2012362107002311 MILANTEX SUS EX ST 12/31/9999 2012362107002211 MILANTEX SUS ORIGINAL 12/31/9999 2012300113039640 MILK OF MAGN SUS 12/31/9999 2012300121043130 MILK OF MAGN SUS 12/31/9999 2012300536247083 MILK OF MAGN SUS 12/31/9999 2012300536247085 MILK OF MAGN SUS 12/31/9999 2012300574001816 MILK OF MAGN SUS 12/31/9999 2012336800039640 MILK OF MAGN SUS 12/31/9999 2012337205045940 MILK OF MAGN SUS 12/31/9999 2012300904078814 MILK OF MAGN SUS 1200/15 12/31/9999 2012300904078816 MILK OF MAGN SUS 1200/15 12/31/9999 2012336800033240 MILK OF MAGN SUS 1200/15 12/31/9999 2012300054356749 MILK OF MAGN SUS 2400MG 12/31/9999 2012300054356761 MILK OF MAGN SUS 2400MG 12/31/9999 2012300113094940 MILK OF MAGN SUS 400/5ML 01/18/2013 2012337205083340 MILK OF MAGN SUS 400/5ML 12/31/9999 2012362011012301 MILK OF MAGN SUS 400/5ML 12/31/9999 2012362011012401 MILK OF MAGN SUS 400/5ML 12/31/9999 2012363868031012 MILK OF MAGN SUS 400/5ML 12/31/9999 2012363868078757 MILK OF MAGN SUS 400/5ML 12/31/9999 2012363868078857 MILK OF MAGN SUS 400/5ML 12/31/9999 2012336800094940 MILK OF MAGN SUS CHERRY 12/31/9999 2012300113033240 MILK OF MAGN SUS FRSH MNT 12/31/9999 2012300904078914 MILK OF MAGN SUS MINT 12/31/9999 2012337205083440 MILK OF MAGN SUS MINT 12/31/9999 2012362107002411 MILK OF MAGN SUS MINT 12/31/9999 2012316477051008 MILLIPRED SOL 10MG/5ML 12/31/9999 2012316477050501 MILLIPRED TAB 5MG 12/31/9999 2012316477050521 MILLIPRED DP PAK 5MG 12/31/9999 2012316477050548 MILLIPRED DP PAK 5MG 12/31/9999 2012316477050748 MILLIPRED DP PAK 5MG 10/31/2013 2012300143970801 MILRINONE INJ 1MG/ML 12/31/9999 2012300143970910 MILRINONE INJ 1MG/ML 12/31/9999 2012300143971010 MILRINONE INJ 1MG/ML 12/31/9999 2012300641606501 MILRINONE INJ 1MG/ML 12/31/9999 2012300641606510 MILRINONE INJ 1MG/ML 12/31/9999 20123