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

61314034201 PHENYLEPHRIN SOL 2.5% OP 12/31/9999 2012361314034202 PHENYLEPHRIN SOL 2.5% OP 12/31/9999 2012300603152054 PHENYLHIST LIQ DH 12/31/9999 2012300603152058 PHENYLHIST LIQ DH 12/31/9999 2012351552090004 PHENYLMERCUR POW BORATE 12/31/9999 2012300378267001 PHENYTEK CAP 200MG 12/31/9999 2012300378267093 PHENYTEK CAP 200MG 12/31/9999 2012300378375001 PHENYTEK CAP 300MG 12/31/9999 2012300378375093 PHENYTEK CAP 300MG 12/31/9999 2012300143988125 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300143988225 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300409131702 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300409184432 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300641049321 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300641049325 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300641255541 PHENYTOIN INJ 50MG/ML 12/31/9999 2012300641255545 PHENYTOIN INJ 50MG/ML 12/31/9999 2012339822405002 PHENYTOIN INJ 50MG/ML 12/31/9999 2012339822405003 PHENYTOIN INJ 50MG/ML 12/31/9999 2012339822405005 PHENYTOIN INJ 50MG/ML 12/31/9999 2012339822405006 PHENYTOIN INJ 50MG/ML 12/31/9999 2012368094053358 PHENYTOIN SUS 100/4ML 12/31/9999 2012300472500208 PHENYTOIN SUS 125/5ML 12/31/9999 2012300472500260 PHENYTOIN SUS 125/5ML 12/31/9999 2012351672406901 PHENYTOIN SUS 125/5ML 12/31/9999 2012359762053101 PHENYTOIN SUS 125/5ML 12/31/9999 2012360432013108 PHENYTOIN SUS 125/5ML 12/31/9999 2012366689003601 PHENYTOIN SUS 125/5ML 12/31/9999 2012366689003650 PHENYTOIN SUS 125/5ML 12/31/9999 2012300378156001 PHENYTOIN EX CAP 100MG 12/31/9999 2012300378156010 PHENYTOIN EX CAP 100MG 12/31/9999 2012350268066011 PHENYTOIN EX CAP 100MG 12/31/9999 2012350268066015 PHENYTOIN EX CAP 100MG 12/31/9999 2012351079090501 PHENYTOIN EX CAP 100MG 12/31/9999 2012351079090517 PHENYTOIN EX CAP 100MG 12/31/9999 2012351079090519 PHENYTOIN EX CAP 100MG 12/31/9999 2012351079090520 PHENYTOIN EX CAP 100MG 12/31/9999 2012351079090556 PHENYTOIN EX CAP 100MG 12/31/9999 2012351672411101 PHENYTOIN EX CAP 100MG 12/31/9999 2012351672411103 PHENYTOIN EX CAP 100MG 12/31/9999 2012362756040201 PHENYTOIN EX CAP 100MG 12/31/9999 2012362756040203 PHENYTOIN EX CAP 100MG 12/31/9999 2012364679072001 PHENYTOIN EX CAP 100MG 12/31/9999 2012364679072002 PHENYTOIN EX CAP 100MG 12/31/9999 2012365162021210 PHENYTOIN EX CAP 100MG 12/31/9999 2012365162021211 PHENYTOIN EX CAP 100MG 12/31/9999 2012365162021250 PHENYTOIN EX CAP 100MG 12/31/9999 2012368084037601 PHENYTOIN EX CAP 100MG 12/31/9999 2012362756029983 PHENYTOIN EX CAP 200MG 12/31/9999 2012362756029988 PHENYTOIN EX CAP 200MG 12/31/9999 2012362756043283 PHENYTOIN EX CAP 300MG 12/31/9999 2012362756043288 PHENYTOIN EX CAP 300MG 12/31/9999 2012316714034701 PHILITH TAB 0.4-35 12/31/2020 2012300024153502 PHISOHEX LIQ 3% 12/31/9999 2012300024153506 PHISOHEX LIQ 3% 12/31/9999 2012300024153548 PHISOHEX LIQ 3% 03/31/2013 2012300126013516 PHOS FLUR SOL 0.044% 12/31/9999 2012300126013816 PHOS FLUR SOL 0.044% 12/31/9999 2012300126013916 PHOS FLUR SOL 0.044% 12/31/9999 2012300126013166 PHOS-FLUR GEL 1.1% 12/31/9999 20123