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

50383063250 POLY-VITAMIN DRO /IRON 12/31/9999 2012359630040030 PONSTEL CAP 250MG 12/31/9999 2012300409184602 PONTOCAINE INJ 1% 11/01/2013 2012300409184906 PONTOCAINE INJ 20MG 01/01/2015 2012300555902058 PORTIA-28 TAB 12/31/9999 2012300409329451 POT ACETATE INJ 2MEQ/ML 12/31/9999 2012300409818301 POT ACETATE INJ 2MEQ/ML 12/31/9999 2012300517205325 POT ACETATE INJ 2MEQ/ML 12/31/9999 2012300517502425 POT ACETATE INJ 4MEQ/ML 12/31/9999 2012351552020706 POT BICARBON GRA 12/31/9999 2012351552016003 POT BITARTRA POW 12/31/9999 2012351552016006 POT BITARTRA POW 12/31/9999 2012351552033906 POT CARBONAT GRA 12/31/9999 2012351552033909 POT CARBONAT GRA 12/31/9999 2012300574018101 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012300574018105 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012300574018190 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012300904606861 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012351477000103 POT CHLORIDE CAP 10MEQ ER 08/31/2015 2012351477000104 POT CHLORIDE CAP 10MEQ ER 07/31/2015 2012362037056001 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012362037056005 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012362037056010 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012362037056090 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012368382070101 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012368382070105 POT CHLORIDE CAP 10MEQ ER 12/31/9999 2012300574018001 POT CHLORIDE CAP 8MEQ ER 12/31/9999 2012351477000204 POT CHLORIDE CAP 8MEQ ER 09/30/2015 2012362037055901 POT CHLORIDE CAP 8MEQ ER 12/31/9999 2012362037055905 POT CHLORIDE CAP 8MEQ ER 12/31/9999 2012368382070201 POT CHLORIDE CAP 8MEQ ER 12/31/9999 2012351552032405 POT CHLORIDE GRA 12/31/9999 2012351552032406 POT CHLORIDE GRA 12/31/9999 2012351552032408 POT CHLORIDE GRA 12/31/9999 2012300338070541 POT CHLORIDE INJ 10MEQ 12/31/9999 2012300338070948 POT CHLORIDE INJ 10MEQ 12/31/9999 2012300409707426 POT CHLORIDE INJ 10MEQ 12/31/9999 2012300409707514 POT CHLORIDE INJ 10MEQ 12/31/9999 2012300338070341 POT CHLORIDE INJ 20MEQ 12/31/9999 2012300338070548 POT CHLORIDE INJ 20MEQ 12/31/9999 2012300409707526 POT CHLORIDE INJ 20MEQ 12/31/9999 2012300409707714 POT CHLORIDE INJ 20MEQ 12/31/9999 2012300264194020 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012300409151302 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012300409663501 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012300409663601 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012300409665106 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012300409665305 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012363323096505 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012363323096510 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012363323096515 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012363323096520 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012363323096730 POT CHLORIDE INJ 2MEQ/ML 12/31/9999 2012300338070348 POT CHLORIDE INJ 40MEQ 12/31/9999 2012300409707726 POT CHLORIDE INJ 40MEQ 12/31/9999 2012300603153258 POT CHLORIDE LIQ 10% 12/31/9999 2012300603153458 POT CHLORIDE LIQ 10% 12/31/9999 2012300603153558 POT CHLORIDE LIQ 10% 12/31/9999 2012300472100016 POT CHLORIDE LIQ 10% SF 12/31/9999 2012300472100028 POT CHLORIDE LIQ 10% SF 12/31/9999 20123