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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658620<strong>01</strong>705 AMOXICILLIN CAP 500MG 12/31/9999 2<strong>01</strong>2367253<strong>01</strong>4110 AMOXICILLIN CAP 500MG 12/31/9999 2<strong>01</strong>2367253<strong>01</strong>4150 AMOXICILLIN CAP 500MG 12/31/9999 2<strong>01</strong>2376439<strong>01</strong>0410 AMOXICILLIN CAP 500MG 12/31/9999 2<strong>01</strong>2376439<strong>01</strong>0450 AMOXICILLIN CAP 500MG 12/31/9999 2<strong>01</strong>23000932267<strong>01</strong> AMOXICILLIN CHW 125MG 12/31/9999 2<strong>01</strong>2363304076020 AMOXICILLIN CHW 200MG 12/31/9999 2<strong>01</strong>23000932268<strong>01</strong> AMOXICILLIN CHW 250MG 12/31/9999 2<strong>01</strong>2300093226805 AMOXICILLIN CHW 250MG 12/31/9999 2<strong>01</strong>23633040515<strong>01</strong> AMOXICILLIN CHW 250MG 12/31/9999 2<strong>01</strong>2363304051504 AMOXICILLIN CHW 250MG 12/31/9999 2<strong>01</strong>23633040761<strong>01</strong> AMOXICILLIN CHW 400MG 12/31/9999 2<strong>01</strong>2363304076120 AMOXICILLIN CHW 400MG 12/31/9999 2<strong>01</strong>2300093415073 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2300093415079 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2300093415080 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>439888<strong>01</strong> AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>43988815 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>43988880 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2300781603946 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2300781603955 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2300781603958 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2343598022252 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2343598022253 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2343598022280 AMOXICILLIN SUS 125/5ML 12/31/9999 2<strong>01</strong>2300093416073 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2300093416076 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2300093416078 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>439886<strong>01</strong> AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>43988650 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>43988675 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2300781615646 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2300781615652 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2300781615657 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2343598022350 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2343598022351 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2343598022352 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2359762102202 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2359762102204 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2359762102207 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>23633040969<strong>01</strong> AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2363304096903 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2363304096904 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>23658620070<strong>01</strong> AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2365862007050 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2365862007075 AMOXICILLIN SUS 200/5ML 12/31/9999 2<strong>01</strong>2300093415573 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2300093415579 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2300093415580 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>439889<strong>01</strong> AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>43988915 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>43988980 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2300781604146 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2300781604155 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2300781604158 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2343598020952 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2343598020953 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2343598020980 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2367253<strong>01</strong>4308 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>2367253<strong>01</strong>4310 AMOXICILLIN SUS 250/5ML 12/31/9999 2<strong>01</strong>23

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