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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62<strong>01</strong>10087<strong>01</strong> NASAL DECONG TAB 120MG ER 12/31/9999 2<strong>01</strong>230<strong>01</strong>13043262 NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2324385043262 NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2324385043280 NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2336800043262 NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2336800043267 NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10078<strong>01</strong> NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>1007802 NASAL DECONG TAB 30MG 12/31/9999 2<strong>01</strong>2361787048250 NASAL EASE POW ALLERGY 12/31/9999 2<strong>01</strong>230<strong>01</strong>13064810 NASAL FOUR SOL 1% 12/31/9999 2<strong>01</strong>2336800064810 NASAL FOUR SOL 1% 12/31/9999 2<strong>01</strong>2336800031213 NASAL MOIST SPR 0.65% 12/31/9999 2<strong>01</strong>2336800031221 NASAL MOIST SPR 0.65% 12/31/9999 2<strong>01</strong>2349348027627 NASAL PUMP SPR 0.05% 12/31/9999 2<strong>01</strong>2345802041059 NASAL RELIEF SPR 0.05% 12/31/9999 2<strong>01</strong>2363868005930 NASAL RELIEF SPR 0.05% 12/31/9999 2<strong>01</strong>2363868006230 NASAL RELIEF SPR 0.05% 12/31/9999 2<strong>01</strong>2300031873120 NASAL RELIEF TAB 5-325MG 12/31/9999 2<strong>01</strong>2300031873220 NASAL RELIEF TAB NIGHT 12/31/9999 2<strong>01</strong>2349348035625 NASAL SALINE SPR 0.65% 12/31/9999 2<strong>01</strong>2349348035984 NASAL SALINE SPR 0.65% 12/31/9999 2<strong>01</strong>2300904597146 NASAL STRIPS MIS LARGE 12/31/9999 2<strong>01</strong>2300904597046 NASAL STRIPS MIS SM/MED 12/31/9999 2<strong>01</strong>2349884027<strong>01</strong>4 NASCOBAL SPR 500MCG 06/30/2<strong>01</strong>3 2<strong>01</strong>2349884027086 NASCOBAL SPR 500MCG 12/31/9999 2<strong>01</strong>2363717032630 NASOHIST DRO 1-2MG/ML 12/31/9999 2<strong>01</strong>2363717032530 NASOHIST DM DRO 12/31/9999 2<strong>01</strong>23000851288<strong>01</strong> NASONEX SPR 50MCG/AC 12/31/9999 2<strong>01</strong>23588090578<strong>01</strong> NASOPEN LIQ 12/31/9999 2<strong>01</strong>2363717027616 NASOTUSS LIQ 11/30/2<strong>01</strong>2 2<strong>01</strong>232438503<strong>01</strong>27 NAT FIBER POW 48.57% 12/31/9999 2<strong>01</strong>2300904519965 NAT FIBER POW THERAPY 12/31/9999 2<strong>01</strong>2300904519966 NAT FIBER POW THERAPY 12/31/9999 2<strong>01</strong>2300603099189 NAT VEG FIBE POW 48.57% 06/30/2<strong>01</strong>6 2<strong>01</strong>2300065064515 NATACYN SUS 5% OP 12/31/9999 2<strong>01</strong>230<strong>01</strong>78071690 NATAFORT TAB 12/31/9999 2<strong>01</strong>2350419040903 NATAZIA TAB 12/31/9999 2<strong>01</strong>23005913355<strong>01</strong> NATEGLINIDE TAB 120MG 12/31/9999 2<strong>01</strong>23498840985<strong>01</strong> NATEGLINIDE TAB 120MG 12/31/9999 2<strong>01</strong>2355111032990 NATEGLINIDE TAB 120MG 12/31/9999 2<strong>01</strong>2368084045921 NATEGLINIDE TAB 120MG 12/31/9999 2<strong>01</strong>23005913354<strong>01</strong> NATEGLINIDE TAB 60MG 12/31/9999 2<strong>01</strong>23498840984<strong>01</strong> NATEGLINIDE TAB 60MG 12/31/9999 2<strong>01</strong>2355111032890 NATEGLINIDE TAB 60MG 12/31/9999 2<strong>01</strong>2368084045821 NATEGLINIDE TAB 60MG 12/31/9999 2<strong>01</strong>23188600752<strong>01</strong> NATELLE ONE CAP 12/31/9999 2<strong>01</strong>2365847020525 NATRECOR INJ 1.5MG 12/31/9999 2<strong>01</strong>2352246092904 NATROBA SUS 0.9% 12/31/9999 2<strong>01</strong>23009045<strong>01</strong>835 NATURAL BAL SOL 0.4% 12/31/9999 2<strong>01</strong>2349348064404 NATURAL HERB LOZ CGH DRP 12/31/9999 2<strong>01</strong>2300603099463 NATURAL VEG POW 58.6% 10/31/2<strong>01</strong>4 2<strong>01</strong>2300536623772 NATURES TEAR SOL 0.4% 12/31/9999 2<strong>01</strong>2324385036638 NATURL FIBER POW 28.3% 12/31/9999 2<strong>01</strong>2300904520065 NATURL FIBER POW THERAPY 12/31/9999 2<strong>01</strong>2300904520066 NATURL FIBER POW THERAPY 12/31/9999 2<strong>01</strong>2350383061604 NAUSEA CONTR SOL 12/31/9999 2<strong>01</strong>2300049573066 NAVANE CAP 5MG 12/31/9999 2<strong>01</strong>23643700532<strong>01</strong> NAVELBINE INJ 10MG/ML 12/31/9999 2<strong>01</strong>2364370053202 NAVELBINE INJ 50MG/5ML 12/31/9999 2<strong>01</strong>2363323087715 NEBUPENT INH 300MG 12/31/9999 2<strong>01</strong>23

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