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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00093733419 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300093733493 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23003782250<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300378225005 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23007812067<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300781206705 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300781206789 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23167290094<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2316729009416 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23510790721<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2351079072120 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23597620703<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2359762070302 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2359762070303 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>23605052968<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2360505296805 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2360505296807 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2360951073470 MYCOPHENOLAT CAP 250MG <strong>01</strong>/31/2<strong>01</strong>3 2<strong>01</strong>2368084<strong>01</strong>77<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2368382<strong>01</strong>30<strong>01</strong> MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2368382<strong>01</strong>3005 MYCOPHENOLAT CAP 250MG 12/31/9999 2<strong>01</strong>2300054<strong>01</strong>6625 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2300054<strong>01</strong>6629 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23000937477<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2300093747705 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23003784472<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2300378447205 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23007815175<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2300781517505 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23167290<strong>01</strong>9<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23167290<strong>01</strong>916 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23510790379<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2351079037920 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23597620702<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2359762070203 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>23605052967<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2360505296705 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2360505296707 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2360951073570 MYCOPHENOLAT TAB 500MG 08/31/2<strong>01</strong>3 2<strong>01</strong>23678770225<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2367877022505 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2368084<strong>01</strong>78<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2368382<strong>01</strong>31<strong>01</strong> MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2368382<strong>01</strong>3105 MYCOPHENOLAT TAB 500MG 12/31/9999 2<strong>01</strong>2300065034203 MYDFRIN SOL 2.5% OP 12/31/9999 2<strong>01</strong>2300998034205 MYDFRIN SOL 2.5% OP 12/31/9999 2<strong>01</strong>2300065035503 MYDRIACYL SOL 1% OP 12/31/9999 2<strong>01</strong>2300998035515 MYDRIACYL SOL 1% OP 12/31/9999 2<strong>01</strong>2300078038566 MYFORTIC TAB 180MG 12/31/9999 2<strong>01</strong>2300078038666 MYFORTIC TAB 360MG 12/31/9999 2<strong>01</strong>2368047023<strong>01</strong>6 MYHIST-DM LIQ 12/31/9999 2<strong>01</strong>2327808000404 MYKIDZ IRON SUS FL 12/31/9999 2<strong>01</strong>230<strong>01</strong>73071325 MYLERAN TAB 2MG 12/31/9999 2<strong>01</strong>2376388071325 MYLERAN TAB 2MG 12/31/9999 2<strong>01</strong>2310454071210 MYOBLOC INJ 10000/2 12/31/9999 2<strong>01</strong>2310454071<strong>01</strong>0 MYOBLOC INJ 2500/0.5 12/31/9999 2<strong>01</strong>2310454071110 MYOBLOC INJ 5000/ML 12/31/9999 2<strong>01</strong>2300067117002 MYOFLEX CRE 10% 12/31/9999 2<strong>01</strong>2300067117004 MYOFLEX CRE 10% 12/31/9999 2<strong>01</strong>236174803<strong>01</strong>11 MYORISAN CAP 10MG 12/31/9999 2<strong>01</strong>23

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