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

63481044070 OPANA ER TAB 40MG 12/31/9999 2012363481069370 OPANA ER TAB 40MG 12/31/9999 2012363481081860 OPANA ER TAB 40MG 12/31/9999 2012363481043470 OPANA ER TAB 5MG 12/31/9999 2012363481081260 OPANA ER TAB 5MG 12/31/9999 2012363481090770 OPANA ER TAB 5MG 12/31/9999 2012363481052270 OPANA ER TAB 7.5MG 12/31/9999 2012300574015904 OPIUM TIN 1% 04/30/2013 2012342799021701 OPIUM TIN 1% 12/31/9999 2012342799021702 OPIUM TIN 1% 12/31/9999 2012342998020301 OPIUM TIN 1% 12/31/9999 2012342998020302 OPIUM TIN 1% 12/31/9999 2012362559015304 OPIUM TIN 1% 12/31/9999 2012316781011606 OPTASE GEL 12/31/9999 2012316781011695 OPTASE GEL 12/31/9999 2012300904299235 OPTI-CLEAR SOL 0.05% OP 12/31/9999 2012364108031111 OPTICS EYE SOL 12/31/9999 2012364108031112 OPTICS EYE SOL 12/31/9999 2012364108021212 OPTICS MINI DRO 12/31/9999 2012364108021213 OPTICS MINI DRO 12/31/9999 2012324208027507 OPTIPRANOLOL SOL 0.3% OP 11/09/2013 2012324208027509 OPTIPRANOLOL SOL 0.3% OP 11/09/2013 2012300407270703 OPTISON INJ 12/31/9999 2012300037702560 OPTIVAR DRO 0.05% 12/31/9999 2012300023324001 OPTIVE DRO 0.5-0.9% 12/31/9999 2012300023324010 OPTIVE DRO 0.5-0.9% 12/31/9999 2012300023324015 OPTIVE DRO 0.5-0.9% 12/31/9999 2012300023341630 OPTIVE DRO 0.5-0.9% 12/31/9999 2012300299382230 ORACEA CAP 40MG 12/31/9999 2012346287001401 ORACIT SOL 12/31/9999 2012346287001415 ORACIT SOL 12/31/9999 2012346287001430 ORACIT SOL 12/31/9999 2012300904602136 ORAL PAIN GEL 20% 12/31/9999 2012300904589935 ORAL PAIN LIQ MAX ST 12/31/9999 2012300904406203 ORAL PEROXID SOL 10% 12/31/9999 2012351672133505 ORALONE PST 0.1% 12/31/9999 2012351552016603 ORANGE CONC LIQ 12/31/9999 2012357844015101 ORAP TAB 1MG 12/31/9999 2012357844018701 ORAP TAB 2MG 12/31/9999 2012359630071008 ORAPRED SOL 15MG/5ML 12/31/9999 2012359630071010 ORAPRED SOL 15MG/5ML 12/31/9999 2012368135045503 ORAPRED SOL 15MG/5ML 12/31/9999 2012359630070048 ORAPRED ODT TAB 10MG 12/31/9999 2012359630070148 ORAPRED ODT TAB 15MG 12/31/9999 2012359630070248 ORAPRED ODT TAB 30MG 12/31/9999 2012354859050301 ORASEP SPR 12/31/9999 2012354859050401 ORASEP SPR 12/31/9999 2012349884008226 ORAVIG TAB 50MG 04/30/2013 2012300095702901 ORBIVAN CAP 12/31/9999 2012359702066101 ORBIVAN CAP 12/31/9999 2012300095707501 ORBIVAN CF TAB 50-300MG 12/31/9999 2012300003218831 ORENCIA INJ 125MG/ML 12/31/9999 2012300003218710 ORENCIA INJ 250MG 12/31/9999 2012366621101006 ORFADIN CAP 10MG 12/31/9999 2012366621100206 ORFADIN CAP 2MG 12/31/9999 2012366621100506 ORFADIN CAP 5MG 12/31/9999 2012300603488621 ORGAN-I NR TAB 200MG 12/31/9999 2012351552098807 ORNITHINE POW HCL 12/31/9999 2012300185071301 ORPH/ASA/CAF TAB 12/31/9999 2012300185071401 ORPHEN CPD TAB DS 11/30/2014 20123