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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00067604556 NICOTINE SYS KIT TRANSDER 12/31/9999 2<strong>01</strong>2300536589588 NICOTINE TD DIS 14MG/24H 12/31/9999 2<strong>01</strong>2337205036174 NICOTINE TD DIS 14MG/24H 12/31/9999 2<strong>01</strong>2300536589688 NICOTINE TD DIS 21MG/24H 12/31/9999 2<strong>01</strong>2337205035874 NICOTINE TD DIS 21MG/24H 12/31/9999 2<strong>01</strong>2300067488<strong>01</strong>4 NICOTINE TD DIS 7MG/24HR 12/31/9999 2<strong>01</strong>2300536589488 NICOTINE TD DIS 7MG/24HR 12/31/9999 2<strong>01</strong>2337205036374 NICOTINE TD DIS 7MG/24HR 12/31/9999 2<strong>01</strong>23005364074<strong>01</strong> NICOTINIC AC CAP 250MG SR 12/31/9999 2<strong>01</strong>23000095400<strong>01</strong> NICOTROL INH 12/31/9999 2<strong>01</strong>230000954<strong>01</strong><strong>01</strong> NICOTROL NS SPR 10MG/ML 12/31/9999 2<strong>01</strong>23000935272<strong>01</strong> NIFEDIAC CC TAB 30MG ER 12/31/9999 2<strong>01</strong>2300093527255 NIFEDIAC CC TAB 30MG ER 12/31/2<strong>01</strong>3 2<strong>01</strong>23000931022<strong>01</strong> NIFEDIAC CC TAB 60MG ER 12/31/9999 2<strong>01</strong>2300093102255 NIFEDIAC CC TAB 60MG ER 12/31/9999 2<strong>01</strong>23000931023<strong>01</strong> NIFEDIAC CC TAB 90MG ER 12/31/9999 2<strong>01</strong>23000930819<strong>01</strong> NIFEDICAL XL TAB 30MG 12/31/9999 2<strong>01</strong>2300093081955 NIFEDICAL XL TAB 30MG 12/31/9999 2<strong>01</strong>23000935173<strong>01</strong> NIFEDICAL XL TAB 60MG 12/31/9999 2<strong>01</strong>2300093517355 NIFEDICAL XL TAB 60MG 12/31/9999 2<strong>01</strong>2300228249710 NIFEDIPINE CAP 10MG 12/31/9999 2<strong>01</strong>2300228249730 NIFEDIPINE CAP 10MG 12/31/9999 2<strong>01</strong>2343386044024 NIFEDIPINE CAP 10MG 12/31/9999 2<strong>01</strong>2300228253<strong>01</strong>0 NIFEDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>2300228253030 NIFEDIPINE CAP 20MG 12/31/9999 2<strong>01</strong>2300093205755 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>23003780353<strong>01</strong> NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2300378035310 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>23003780480<strong>01</strong> NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2300378048030 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>23003783475<strong>01</strong> NIFEDIPINE TAB 30MG ER 06/30/2<strong>01</strong>4 2<strong>01</strong>2300378347530 NIFEDIPINE TAB 30MG ER 08/31/2<strong>01</strong>4 2<strong>01</strong>2350268059715 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>23510790400<strong>01</strong> NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2351079040020 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>23510790940<strong>01</strong> NIFEDIPINE TAB 30MG ER 05/31/2<strong>01</strong>3 2<strong>01</strong>2351079094020 NIFEDIPINE TAB 30MG ER 05/31/2<strong>01</strong>3 2<strong>01</strong>2354458095<strong>01</strong>0 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2359762669003 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2359762669005 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2359762669008 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2362175026037 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2362175026043 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2362175026046 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2362175026055 NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>2367767<strong>01</strong>53<strong>01</strong> NIFEDIPINE TAB 30MG ER 12/31/9999 2<strong>01</strong>23003780360<strong>01</strong> NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>2300378036<strong>01</strong>0 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>23003780481<strong>01</strong> NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>2300378048130 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>23003783482<strong>01</strong> NIFEDIPINE TAB 60MG ER 10/31/2<strong>01</strong>4 2<strong>01</strong>2300378348230 NIFEDIPINE TAB 60MG ER 10/31/2<strong>01</strong>4 2<strong>01</strong>2350268059815 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>23510790896<strong>01</strong> NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>2351079089620 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>23510790968<strong>01</strong> NIFEDIPINE TAB 60MG ER 08/31/2<strong>01</strong>3 2<strong>01</strong>2351079096820 NIFEDIPINE TAB 60MG ER 08/31/2<strong>01</strong>3 2<strong>01</strong>2354458094808 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>2359762669103 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>2359762669105 NIFEDIPINE TAB 60MG ER 12/31/9999 2<strong>01</strong>23

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