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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00074308090 NIASPAN TAB 1000 ER 12/31/9999 2<strong>01</strong>2300074307490 NIASPAN TAB 500MG ER 12/31/9999 2<strong>01</strong>2300074307990 NIASPAN TAB 750MG ER 12/31/9999 2<strong>01</strong>2300378102005 NICARDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>2300378102077 NICARDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>234280605<strong>01</strong><strong>01</strong> NICARDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>234280605<strong>01</strong>05 NICARDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>234280605<strong>01</strong>09 NICARDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>2300378143005 NICARDIPINE CAP 30MG 12/31/9999 2<strong>01</strong>2300378143077 NICARDIPINE CAP 30MG 12/31/9999 2<strong>01</strong>23428060502<strong>01</strong> NICARDIPINE CAP 30MG 12/31/9999 2<strong>01</strong>2342806050205 NICARDIPINE CAP 30MG 12/31/9999 2<strong>01</strong>2342806050209 NICARDIPINE CAP 30MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>43968910 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>2300781320470 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>2300781320495 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>2300781932470 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>2300781932495 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>231<strong>01</strong>39070<strong>01</strong>0 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>231<strong>01</strong>39070<strong>01</strong>1 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>2341616088244 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>23646790631<strong>01</strong> NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>2364679063102 NICARDIPINE INJ 25/10ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9502 NICODERM CQ DIS 14MG/24H 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9503 NICODERM CQ DIS 14MG/24H 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>4502 NICODERM CQ DIS 21MG/24H 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>94<strong>01</strong> NICODERM CQ DIS 21MG/24H 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9402 NICODERM CQ DIS 21MG/24H 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9403 NICODERM CQ DIS 21MG/24H 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>47<strong>01</strong> NICODERM CQ DIS 7MG/24HR 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>4702 NICODERM CQ DIS 7MG/24HR 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9602 NICODERM CQ DIS 7MG/24HR 12/31/9999 2<strong>01</strong>2300904573611 NICORELIEF GUM 2MG MINT 12/31/9999 2<strong>01</strong>2300904573651 NICORELIEF GUM 2MG MINT 12/31/9999 2<strong>01</strong>2300904573411 NICORELIEF GUM 2MG ORIG 12/31/9999 2<strong>01</strong>2300904573451 NICORELIEF GUM 2MG ORIG 12/31/9999 2<strong>01</strong>2300904573711 NICORELIEF GUM 4MG MINT 12/31/9999 2<strong>01</strong>2300904573751 NICORELIEF GUM 4MG MINT 12/31/9999 2<strong>01</strong>2300904573511 NICORELIEF GUM 4MG ORIG 12/31/9999 2<strong>01</strong>2300904573551 NICORELIEF GUM 4MG ORIG 12/31/9999 2<strong>01</strong>2300904625762 NICORELIEF LOZ 2MG 12/31/9999 2<strong>01</strong>2300904625862 NICORELIEF LOZ 4MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>5702 NICORETTE GUM 2MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>9702 NICORETTE GUM 2MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>350466<strong>01</strong> NICORETTE GUM 2MG CINN 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046602 NICORETTE GUM 2MG CINN 12/31/9999 2<strong>01</strong>230<strong>01</strong>35046603 NICORETTE GUM 2MG CINN 12/31/9999 2<strong>01</strong>230<strong>01</strong>350225<strong>01</strong> NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35022503 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35022904 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35022905 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35047402 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35047403 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35047405 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35047407 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35047408 NICORETTE GUM 2MG MINT 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>5709 NICORETTE GUM 2MG ORIG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>5710 NICORETTE GUM 2MG ORIG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>5711 NICORETTE GUM 2MG ORIG 12/31/9999 2<strong>01</strong>230<strong>01</strong>35<strong>01</strong>57<strong>01</strong> NICORETTE GUM 2MG REF 12/31/9999 2<strong>01</strong>23

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