Rebatable Drug List for Iowa Medicaid Effective Date December 01 ...

00407141234 OMNIPAQUE INJ 240MG/ML 12/31/9999 2012300407141235 OMNIPAQUE INJ 240MG/ML 12/31/9999 2012300407141238 OMNIPAQUE INJ 240MG/ML 12/31/9999 2012300407141240 OMNIPAQUE INJ 240MG/ML 03/31/2013 2012300407141249 OMNIPAQUE INJ 240MG/ML 04/01/2013 2012300407141250 OMNIPAQUE INJ 240MG/ML 12/31/9999 2012300407141260 OMNIPAQUE INJ 240MG/ML 12/31/9999 2012300407141284 OMNIPAQUE INJ 240MG/ML 02/03/2013 2012300407141310 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141330 OMNIPAQUE INJ 300MG/ML 10/01/2013 2012300407141341 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141342 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141343 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141346 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141350 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141351 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141353 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141359 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141360 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141361 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141362 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141363 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141365 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141366 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141368 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141386 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141387 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141388 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141389 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141390 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141391 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141392 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141393 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141394 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141395 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141396 OMNIPAQUE INJ 300MG/ML 12/31/9999 2012300407141403 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141404 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141421 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141422 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141423 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141424 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141425 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141441 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141442 OMNIPAQUE INJ 350MG/ML 04/01/2013 2012300407141444 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141445 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141450 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141451 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141452 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141453 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141460 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141476 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141482 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141484 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141485 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141486 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141487 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141488 OMNIPAQUE INJ 350MG/ML 12/31/9999 2012300407141489 OMNIPAQUE INJ 350MG/ML 12/31/9999 20123