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

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64679074202 RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>2364679074204 RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>23646790907<strong>01</strong> RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>2364679090702 RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>2364679090704 RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>23684620249<strong>01</strong> RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>2368462024920 RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>2368462024930 RANITIDINE TAB 300MG 12/31/9999 2<strong>01</strong>2300904581846 RANITIDINE TAB 75MG 12/31/9999 2<strong>01</strong>2300904581852 RANITIDINE TAB 75MG 12/31/9999 2<strong>01</strong>2337205053165 RANITIDINE TAB 75MG 12/31/9999 2<strong>01</strong>2337205053172 RANITIDINE TAB 75MG 12/31/9999 2<strong>01</strong>2352544<strong>01</strong>5130 RAPAFLO CAP 4MG 12/31/9999 2<strong>01</strong>2352544<strong>01</strong>5219 RAPAFLO CAP 8MG 12/31/9999 2<strong>01</strong>2352544<strong>01</strong>5230 RAPAFLO CAP 8MG 12/31/9999 2<strong>01</strong>2300008103004 RAPAMUNE SOL 1MG/ML 12/31/9999 2<strong>01</strong>2300008103006 RAPAMUNE SOL 1MG/ML 12/31/9999 2<strong>01</strong>2300008104005 RAPAMUNE TAB 0.5MG 12/31/9999 2<strong>01</strong>2300008104<strong>01</strong>0 RAPAMUNE TAB 0.5MG 12/31/9999 2<strong>01</strong>2300008104105 RAPAMUNE TAB 1MG 12/31/9999 2<strong>01</strong>2300008104110 RAPAMUNE TAB 1MG 12/31/9999 2<strong>01</strong>2300008104205 RAPAMUNE TAB 2MG 12/31/9999 2<strong>01</strong>2351552023603 RASPBERRY LIQ FLAVOR 12/31/9999 2<strong>01</strong>2350458049<strong>01</strong>0 RAZADYNE SOL 4MG/ML 12/31/9999 2<strong>01</strong>2350458039860 RAZADYNE TAB 12MG 12/31/9999 2<strong>01</strong>2350458039660 RAZADYNE TAB 4MG 12/31/9999 2<strong>01</strong>2350458039760 RAZADYNE TAB 8MG 12/31/9999 2<strong>01</strong>2350458038830 RAZADYNE ER CAP 16MG 12/31/9999 2<strong>01</strong>2350458038930 RAZADYNE ER CAP 24MG 12/31/9999 2<strong>01</strong>2350458038730 RAZADYNE ER CAP 8MG 12/31/9999 2<strong>01</strong>2351552118106 RDT BASE POW 12/31/9999 2<strong>01</strong>2351552118108 RDT BASE POW 12/31/9999 2<strong>01</strong>23006423<strong>01</strong>030 REAPHIRM CAP 12/31/9999 2<strong>01</strong>2300085119403 REBETOL CAP 200MG 12/31/9999 2<strong>01</strong>2300085135105 REBETOL CAP 200MG 12/31/9999 2<strong>01</strong>2300085138507 REBETOL CAP 200MG 12/31/9999 2<strong>01</strong>23000851318<strong>01</strong> REBETOL SOL 40MG/ML 12/31/9999 2<strong>01</strong>2344087002203 REBIF INJ 22/0.5 12/31/9999 2<strong>01</strong>2344087004403 REBIF INJ 44/0.5 12/31/9999 2<strong>01</strong>23440878822<strong>01</strong> REBIF TITRTN SOL PACK 12/31/9999 2<strong>01</strong>2300078043561 RECLAST INJ 5/100ML 12/31/9999 2<strong>01</strong>2352544095428 RECLIPSEN TAB 12/31/9999 2<strong>01</strong>2300944283410 RECOMBINATE INJ 06/02/2<strong>01</strong>3 2<strong>01</strong>2300944284410 RECOMBINATE INJ 12/31/9999 2<strong>01</strong>2300944284510 RECOMBINATE INJ 12/31/9999 2<strong>01</strong>2300944284110 RECOMBINATE INJ 220-400 12/31/9999 2<strong>01</strong>2300944283210 RECOMBINATE INJ 4<strong>01</strong>-800 04/26/2<strong>01</strong>3 2<strong>01</strong>2300944284210 RECOMBINATE INJ 4<strong>01</strong>-800 12/31/9999 2<strong>01</strong>2300944283310 RECOMBINATE INJ 8<strong>01</strong>-1240 04/26/2<strong>01</strong>3 2<strong>01</strong>2300944284310 RECOMBINATE INJ 8<strong>01</strong>-1240 12/31/9999 2<strong>01</strong>2342747023530 RECTIV OIN 0.4% 12/31/9999 2<strong>01</strong>2351552100407 RED YEAST POW RICE 12/31/9999 2<strong>01</strong>23503830<strong>01</strong><strong>01</strong>5 REDNESS RELI SOL EYE DROP 12/31/9999 2<strong>01</strong>2313548063840 REFISSA CRE 0.05% 02/28/2<strong>01</strong>4 2<strong>01</strong>2366530041149 REFISSA CRE 0.05% 12/31/9999 2<strong>01</strong>2350419<strong>01</strong>5057 REFLUDAN INJ 50MG 12/31/9999 2<strong>01</strong>2300023920515 REFRESH DRO 1% OP 12/31/9999 2<strong>01</strong>23000230506<strong>01</strong> REFRESH DRO OP 12/31/9999 2<strong>01</strong>2300023050650 REFRESH DRO OP 12/31/9999 2<strong>01</strong>2300023341415 REFRESH DRO RELIEF 12/31/9999 2<strong>01</strong>23

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