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

68462022517 MOMETASONE OIN 0.1% 12/31/9999 2012368462022555 MOMETASONE OIN 0.1% 12/31/9999 2012300115147154 MOMETASONE SOL 0.1% 12/31/9999 2012300115147155 MOMETASONE SOL 0.1% 12/31/9999 2012300168027230 MOMETASONE SOL 0.1% 12/31/9999 2012300168027260 MOMETASONE SOL 0.1% 12/31/9999 2012300713070153 MOMETASONE SOL 0.1% 12/31/9999 2012300713070185 MOMETASONE SOL 0.1% 12/31/9999 2012300781706730 MOMETASONE SOL 0.1% 03/31/2014 2012300781706761 MOMETASONE SOL 0.1% 02/28/2014 2012345802011846 MOMETASONE SOL 0.1% 12/31/9999 2012345802011859 MOMETASONE SOL 0.1% 12/31/9999 2012351672130503 MOMETASONE SOL 0.1% 12/31/9999 2012351672130504 MOMETASONE SOL 0.1% 12/31/9999 2012367405027530 MOMETASONE SOL 0.1% 12/31/9999 2012367405027560 MOMETASONE SOL 0.1% 12/31/9999 2012368462038502 MOMETASONE SOL 0.1% 12/31/9999 2012368462038537 MOMETASONE SOL 0.1% 12/31/9999 2012368712003201 MOMEXIN KIT 12/31/9999 2012300053763302 MONOCLATE-P INJ 1000UNIT 12/31/9999 2012300053763402 MONOCLATE-P INJ 1500UNIT 12/31/9999 2012300091361001 MONOKET TAB 10MG 04/30/2013 2012300091362001 MONOKET TAB 20MG 04/30/2013 2012352544024728 MONONESSA TAB 12/31/9999 2012300053623302 MONONINE INJ 1000UNIT 12/31/9999 2012300053766804 MONONINE INJ 1000UNIT 01/07/2013 2012300054028813 MONTELUKAST CHW 4MG 12/31/9999 2012300054028822 MONTELUKAST CHW 4MG 12/31/9999 2012300093742456 MONTELUKAST CHW 4MG 12/31/9999 2012300093742498 MONTELUKAST CHW 4MG 12/31/9999 2012300378520493 MONTELUKAST CHW 4MG 12/31/9999 2012300603465302 MONTELUKAST CHW 4MG 12/31/9999 2012300603465316 MONTELUKAST CHW 4MG 12/31/9999 2012300781555431 MONTELUKAST CHW 4MG 12/31/9999 2012300781555492 MONTELUKAST CHW 4MG 12/31/9999 2012313668007930 MONTELUKAST CHW 4MG 12/31/9999 2012313668007990 MONTELUKAST CHW 4MG 12/31/9999 2012355111059330 MONTELUKAST CHW 4MG 12/31/9999 2012355111059390 MONTELUKAST CHW 4MG 12/31/9999 2012359762004501 MONTELUKAST CHW 4MG 12/31/9999 2012359762004502 MONTELUKAST CHW 4MG 12/31/9999 2012360505357303 MONTELUKAST CHW 4MG 12/31/9999 2012360505357308 MONTELUKAST CHW 4MG 12/31/9999 2012360505357309 MONTELUKAST CHW 4MG 12/31/9999 2012362175020432 MONTELUKAST CHW 4MG 12/31/9999 2012362175020446 MONTELUKAST CHW 4MG 12/31/9999 2012365862056705 MONTELUKAST CHW 4MG 12/31/9999 2012365862056730 MONTELUKAST CHW 4MG 12/31/9999 2012365862056790 MONTELUKAST CHW 4MG 12/31/9999 2012300054028913 MONTELUKAST CHW 5MG 12/31/9999 2012300054028922 MONTELUKAST CHW 5MG 12/31/9999 2012300093742556 MONTELUKAST CHW 5MG 12/31/9999 2012300093742598 MONTELUKAST CHW 5MG 12/31/9999 2012300378520593 MONTELUKAST CHW 5MG 12/31/9999 2012300603465402 MONTELUKAST CHW 5MG 12/31/9999 2012300603465416 MONTELUKAST CHW 5MG 12/31/9999 2012300781555531 MONTELUKAST CHW 5MG 12/31/9999 2012300781555592 MONTELUKAST CHW 5MG 12/31/9999 2012313668008030 MONTELUKAST CHW 5MG 12/31/9999 2012313668008090 MONTELUKAST CHW 5MG 12/31/9999 20123