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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00603438121 MULTI-VIT/FL CHW 0.25MG 12/31/9999 2<strong>01</strong>23643760813<strong>01</strong> MULTI-VIT/FL CHW 0.25MG 12/31/9999 2<strong>01</strong>2300603438221 MULTI-VIT/FL CHW 0.5MG 12/31/9999 2<strong>01</strong>23643760814<strong>01</strong> MULTI-VIT/FL CHW 0.5MG 12/31/9999 2<strong>01</strong>2300603438321 MULTI-VIT/FL CHW 1MG 12/31/9999 2<strong>01</strong>23643760815<strong>01</strong> MULTI-VIT/FL CHW 1MG 12/31/9999 2<strong>01</strong>2364376082150 MULTI-VIT/FL DRO /FE 0.25 12/31/9999 2<strong>01</strong>2300603144947 MULTI-VIT/FL DRO 0.25MG 12/31/9999 2<strong>01</strong>2351862<strong>01</strong>6150 MULTI-VIT/FL DRO 0.25MG 12/31/9999 2<strong>01</strong>2364376082050 MULTI-VIT/FL DRO 0.25MG 12/31/9999 2<strong>01</strong>2300603145047 MULTI-VIT/FL DRO 0.5MG/ML 12/31/9999 2<strong>01</strong>2351862<strong>01</strong>6250 MULTI-VIT/FL DRO 0.5MG/ML 12/31/9999 2<strong>01</strong>2364376082250 MULTI-VIT/FL DRO 0.5MG/ML 12/31/9999 2<strong>01</strong>2300536404610 MULTIVITAMIN TAB 12/31/9999 2<strong>01</strong>2363868061460 MULTIVITAMIN TAB WOMENS 12/31/9999 2<strong>01</strong>2363868061930 MULTI-VITE TAB 12/31/9999 2<strong>01</strong>23638680620<strong>01</strong> MULTI-VITE TAB 50&OVER 12/31/9999 2<strong>01</strong>2363868062030 MULTI-VITE TAB 50&OVER 12/31/9999 2<strong>01</strong>2363868062060 MULTI-VITE TAB 50&OVER 12/31/9999 2<strong>01</strong>2363868061913 MULTI-VITE TAB PLUS 12/31/9999 2<strong>01</strong>2351862<strong>01</strong>52<strong>01</strong> MULT-VIT/FL CHW 0.5MG 12/31/9999 2<strong>01</strong>23000931<strong>01</strong>042 MUPIROCIN OIN 2% 12/31/9999 2<strong>01</strong>230<strong>01</strong>68035222 MUPIROCIN OIN 2% 12/31/9999 2<strong>01</strong>2345802<strong>01</strong>1222 MUPIROCIN OIN 2% 12/31/9999 2<strong>01</strong>2351672131200 MUPIROCIN OIN 2% 12/31/9999 2<strong>01</strong>2368462<strong>01</strong>8022 MUPIROCIN OIN 2% 12/31/9999 2<strong>01</strong>2324208038555 MURO 128 OIN 5% OP 12/31/9999 2<strong>01</strong>2324208038556 MURO 128 OIN 5% OP 12/31/9999 2<strong>01</strong>2324208027615 MURO 128 SOL 2% OP 12/31/9999 2<strong>01</strong>2324208027715 MURO 128 SOL 5% OP 12/31/9999 2<strong>01</strong>2324208027730 MURO 128 SOL 5% OP 12/31/9999 2<strong>01</strong>2324208028<strong>01</strong>5 MUROCEL SOL 1% OP 07/18/2<strong>01</strong>3 2<strong>01</strong>2345802<strong>01</strong>7453 MUSCLE RUB CRE 12/31/9999 2<strong>01</strong>230<strong>01</strong>13004926 MUSCLE RUB CRE ULTRA ST 12/31/9999 2<strong>01</strong>2300713062504 MUSCLE RUB CRE ULTRA ST 12/31/9999 2<strong>01</strong>2349348088285 MUSCLE RUB CRE ULTRA ST 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10038<strong>01</strong> MUSCLE RUB CRE ULTRA ST 12/31/9999 2<strong>01</strong>2300037814006 MUSE SUP 1000MCG 12/31/9999 2<strong>01</strong>2362541<strong>01</strong>40<strong>01</strong> MUSE SUP 1000MCG 07/31/2<strong>01</strong>3 2<strong>01</strong>2362541<strong>01</strong>4006 MUSE SUP 1000MCG 07/31/2<strong>01</strong>3 2<strong>01</strong>2300037811006 MUSE SUP 125MCG 12/31/9999 2<strong>01</strong>2300037812006 MUSE SUP 250MCG 12/31/9999 2<strong>01</strong>2362541<strong>01</strong>20<strong>01</strong> MUSE SUP 250MCG 12/31/2<strong>01</strong>2 2<strong>01</strong>2362541<strong>01</strong>2006 MUSE SUP 250MCG 12/31/2<strong>01</strong>2 2<strong>01</strong>2300037813006 MUSE SUP 500MCG 12/31/9999 2<strong>01</strong>2362541<strong>01</strong>30<strong>01</strong> MUSE SUP 500MCG 07/31/2<strong>01</strong>3 2<strong>01</strong>2362541<strong>01</strong>3006 MUSE SUP 500MCG 07/31/2<strong>01</strong>3 2<strong>01</strong>2367386091151 MUSTARGEN INJ 10MG 12/31/9999 2<strong>01</strong>23128300800<strong>01</strong> M-VIT TAB 27-1MG 12/31/9999 2<strong>01</strong>23688500<strong>01</strong>0<strong>01</strong> MYAMBUTOL TAB 100MG 12/31/9999 2<strong>01</strong>23688500<strong>01</strong>2<strong>01</strong> MYAMBUTOL TAB 400MG 12/31/9999 2<strong>01</strong>23688500<strong>01</strong>202 MYAMBUTOL TAB 400MG 12/31/9999 2<strong>01</strong>23688500<strong>01</strong>203 MYAMBUTOL TAB 400MG 12/31/9999 2<strong>01</strong>2300469321110 MYCAMINE INJ 100MG 12/31/9999 2<strong>01</strong>2300469325<strong>01</strong>0 MYCAMINE INJ 50MG 12/31/9999 2<strong>01</strong>2300<strong>01</strong>353<strong>01</strong>17 MYCOBUTIN CAP 150MG 12/31/9999 2<strong>01</strong>2300054<strong>01</strong>6325 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300054<strong>01</strong>6329 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23000937334<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300093733405 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23

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