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

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63323029750 PROPOVEN INJ 10MG/ML 12/31/9999 2<strong>01</strong>2363323029751 PROPOVEN INJ 10MG/ML 12/31/9999 2<strong>01</strong>2363323029753 PROPOVEN INJ 10MG/ML 12/31/9999 2<strong>01</strong>2363323029766 PROPOVEN INJ 10MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>433235<strong>01</strong> PROPOXY HCL CAP 65MG 12/31/9999 2<strong>01</strong>23003787065<strong>01</strong> PROPOXY HCL CAP 65MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>30<strong>01</strong> PROPOXY/APAP TAB 65-650MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>3005 PROPOXY/APAP TAB 65-650MG 12/31/9999 2<strong>01</strong>23003780731<strong>01</strong> PROPRAN/HCTZ TAB 40/25 12/31/9999 2<strong>01</strong>2300228236050 PROPRAN/HCTZ TAB 80/25 12/31/9999 2<strong>01</strong>23003780347<strong>01</strong> PROPRAN/HCTZ TAB 80/25 12/31/9999 2<strong>01</strong>2300228278<strong>01</strong>1 PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>2300228278050 PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>2300245008610 PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>2300245008611 PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>23003786220<strong>01</strong> PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>2300378622005 PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>2343478090288 PROPRANOLOL CAP 120MG ER 12/31/9999 2<strong>01</strong>23498840329<strong>01</strong> PROPRANOLOL CAP 120MG ER 03/31/2<strong>01</strong>3 2<strong>01</strong>2300228278111 PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>2300228278150 PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>2300245008710 PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>2300245008711 PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>23003786260<strong>01</strong> PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>2300378626005 PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>2343478090388 PROPRANOLOL CAP 160MG ER 12/31/9999 2<strong>01</strong>23498840330<strong>01</strong> PROPRANOLOL CAP 160MG ER 03/31/2<strong>01</strong>3 2<strong>01</strong>2300228277811 PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>2300228277850 PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>2300245008410 PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>2300245008411 PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>23003786160<strong>01</strong> PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>2300378616005 PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>2343478090088 PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>23498840282<strong>01</strong> PROPRANOLOL CAP 60MG ER 03/31/2<strong>01</strong>3 2<strong>01</strong>2349884028210 PROPRANOLOL CAP 60MG ER <strong>01</strong>/31/2<strong>01</strong>3 2<strong>01</strong>23680840209<strong>01</strong> PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>23680840503<strong>01</strong> PROPRANOLOL CAP 60MG ER 12/31/9999 2<strong>01</strong>2300228277911 PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>2300228277950 PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>2300245008510 PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>2300245008511 PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>23003786180<strong>01</strong> PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>2300378618005 PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>234347809<strong>01</strong>88 PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>23498840328<strong>01</strong> PROPRANOLOL CAP 80MG ER <strong>01</strong>/31/2<strong>01</strong>3 2<strong>01</strong>2349884032810 PROPRANOLOL CAP 80MG ER <strong>01</strong>/31/2<strong>01</strong>3 2<strong>01</strong>23680840210<strong>01</strong> PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>23680840504<strong>01</strong> PROPRANOLOL CAP 80MG ER 12/31/9999 2<strong>01</strong>230<strong>01</strong>439872<strong>01</strong> PROPRANOLOL INJ 1MG/ML 12/31/9999 2<strong>01</strong>2300781377795 PROPRANOLOL INJ 1MG/ML 12/31/9999 2<strong>01</strong>2355390000310 PROPRANOLOL INJ 1MG/ML 12/31/9999 2<strong>01</strong>23633230604<strong>01</strong> PROPRANOLOL INJ 1MG/ML 12/31/9999 2<strong>01</strong>2300054372763 PROPRANOLOL SOL 20MG/5ML 12/31/9999 2<strong>01</strong>2300054373063 PROPRANOLOL SOL 40MG/5ML 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>82<strong>01</strong> PROPRANOLOL TAB 10MG 12/31/9999 2<strong>01</strong>2300378<strong>01</strong>8210 PROPRANOLOL TAB 10MG 12/31/9999 2<strong>01</strong>23005915554<strong>01</strong> PROPRANOLOL TAB 10MG 12/31/9999 2<strong>01</strong>2300591555410 PROPRANOLOL TAB 10MG 12/31/9999 2<strong>01</strong>2300603548221 PROPRANOLOL TAB 10MG 12/31/9999 2<strong>01</strong>23

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