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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60258052530 NEUTRAHIST DRO 0.8-9MG 12/31/9999 2<strong>01</strong>2360258052630 NEUTRAHIST DRO 9-0.8-3 12/31/9999 2<strong>01</strong>2300065000203 NEVANAC SUS 0.1% 12/31/9999 2<strong>01</strong>2300054045058 NEVIRAPINE SUS 50MG/5ML 12/31/9999 2<strong>01</strong>2300054045921 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2300378405091 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2313925050060 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2331722050560 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2351991033106 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2360505378806 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2365862002760 NEVIRAPINE TAB 200MG 12/31/9999 2<strong>01</strong>2300245037430 NEXA PLUS CAP 12/31/9999 2<strong>01</strong>2300245024430 NEXA SELECT CAP 12/31/9999 2<strong>01</strong>2350419048858 NEXAVAR TAB 200MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86502031 NEXIUM CAP 20MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86502054 NEXIUM CAP 20MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86502082 NEXIUM CAP 20MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86502228 NEXIUM CAP 20MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504031 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504035 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504054 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504055 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504082 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504085 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504225 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>86504228 NEXIUM CAP 40MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>864<strong>01</strong>0<strong>01</strong> NEXIUM GRA 10MG DR 12/31/9999 2<strong>01</strong>230<strong>01</strong>864025<strong>01</strong> NEXIUM GRA 2.5MG DR 12/31/9999 2<strong>01</strong>230<strong>01</strong>864020<strong>01</strong> NEXIUM GRA 20MG DR 12/31/9999 2<strong>01</strong>230<strong>01</strong>864040<strong>01</strong> NEXIUM GRA 40MG DR 12/31/9999 2<strong>01</strong>230<strong>01</strong>864050<strong>01</strong> NEXIUM GRA 5MG DR 12/31/9999 2<strong>01</strong>230<strong>01</strong>866020<strong>01</strong> NEXIUM I.V. INJ 20MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>866040<strong>01</strong> NEXIUM I.V. INJ 40MG 12/31/9999 2<strong>01</strong>23000520274<strong>01</strong> NEXPLANON IMP 68MG 12/31/9999 2<strong>01</strong>2352544027536 NEXT CHOICE TAB 0.75MG 12/31/9999 2<strong>01</strong>2352544028754 NEXT CHOICE TAB 1.5MG 12/31/9999 2<strong>01</strong>2343066<strong>01</strong>5<strong>01</strong>0 NEXTERONE INJ 12/31/9999 2<strong>01</strong>2343066036020 NEXTERONE INJ 12/31/9999 2<strong>01</strong>23494830<strong>01</strong>4<strong>01</strong> NIACIN CAP 250MG SR 12/31/9999 2<strong>01</strong>23494830<strong>01</strong>410 NIACIN CAP 250MG SR 12/31/9999 2<strong>01</strong>23005364077<strong>01</strong> NIACIN CAP 500MG SR 12/31/9999 2<strong>01</strong>23494830<strong>01</strong>8<strong>01</strong> NIACIN CAP 500MG SR 12/31/9999 2<strong>01</strong>23494830<strong>01</strong>810 NIACIN CAP 500MG SR 12/31/9999 2<strong>01</strong>2351552055905 NIACIN POW 12/31/9999 2<strong>01</strong>2351552055906 NIACIN POW 12/31/9999 2<strong>01</strong>2351552055907 NIACIN POW 12/31/9999 2<strong>01</strong>23005364076<strong>01</strong> NIACIN TAB 100MG 12/31/9999 2<strong>01</strong>2300536407610 NIACIN TAB 100MG 12/31/9999 2<strong>01</strong>23102670<strong>01</strong>2<strong>01</strong> NIACIN TAB 100MG 12/31/9999 2<strong>01</strong>23102670<strong>01</strong>204 NIACIN TAB 100MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>824405<strong>01</strong> NIACIN TAB 500MG 12/31/9999 2<strong>01</strong>2300536407810 NIACIN TAB 500MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>824417<strong>01</strong> NIACIN TAB 500MG TD 12/31/9999 2<strong>01</strong>23005367030<strong>01</strong> NIACIN TAB 500MG TR 12/31/9999 2<strong>01</strong>23005364070<strong>01</strong> NIACIN TAB 50MG 12/31/9999 2<strong>01</strong>23005367033<strong>01</strong> NIACIN TAB 750MG TR 12/31/9999 2<strong>01</strong>23005367038<strong>01</strong> NIACIN TR TAB 1000MG 12/31/9999 2<strong>01</strong>23005364068<strong>01</strong> NIACINAMIDE TAB 100MG 12/31/9999 2<strong>01</strong>23005364069<strong>01</strong> NIACINAMIDE TAB 500MG 12/31/9999 2<strong>01</strong>2300245006711 NIACOR TAB 500MG 12/31/9999 2<strong>01</strong>23

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