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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53329<strong>01</strong>5713 REMEDY NUTRA CRE 1% 12/31/9999 2<strong>01</strong>2353329<strong>01</strong>5796 REMEDY NUTRA CRE 1% 12/31/9999 2<strong>01</strong>2353329<strong>01</strong>6104 REMEDY SKIN CRE REPAIR 12/31/9999 2<strong>01</strong>2353329<strong>01</strong>6113 REMEDY SKIN CRE REPAIR 12/31/9999 2<strong>01</strong>2353329<strong>01</strong>6123 REMEDY SKIN CRE REPAIR 12/31/9999 2<strong>01</strong>2353329<strong>01</strong>6196 REMEDY SKIN CRE REPAIR 12/31/9999 2<strong>01</strong>2300052<strong>01</strong>0530 REMERON TAB 15MG 12/31/9999 2<strong>01</strong>2300052<strong>01</strong>0730 REMERON TAB 30MG 12/31/9999 2<strong>01</strong>2300052<strong>01</strong>0930 REMERON TAB 45MG 12/31/9999 2<strong>01</strong>2300052<strong>01</strong>0630 REMERON SLTB TAB 15MG 12/31/9999 2<strong>01</strong>2300052<strong>01</strong>0830 REMERON SLTB TAB 30MG 12/31/9999 2<strong>01</strong>2300052<strong>01</strong>1030 REMERON SLTB TAB 45MG 12/31/9999 2<strong>01</strong>2358980068050 REMEVEN CRE 50% 12/31/9999 2<strong>01</strong>2358980068090 REMEVEN CRE 50% 12/31/9999 2<strong>01</strong>23578940030<strong>01</strong> REMICADE INJ 100MG 12/31/9999 2<strong>01</strong>2366302<strong>01</strong>10<strong>01</strong> REMODULIN INJ 10MG/ML 12/31/9999 2<strong>01</strong>2366302<strong>01</strong><strong>01</strong><strong>01</strong> REMODULIN INJ 1MG/ML 12/31/9999 2<strong>01</strong>2366302<strong>01</strong>02<strong>01</strong> REMODULIN INJ 2.5MG/ML 12/31/9999 2<strong>01</strong>2366302<strong>01</strong>05<strong>01</strong> REMODULIN INJ 5MG/ML 12/31/9999 2<strong>01</strong>23003270<strong>01</strong>105 RENACIDIN SOL IRR 12/31/9999 2<strong>01</strong>23584680020<strong>01</strong> RENAGEL TAB 400MG 12/31/9999 2<strong>01</strong>23584680021<strong>01</strong> RENAGEL TAB 800MG 12/31/9999 2<strong>01</strong>2360258<strong>01</strong>62<strong>01</strong> RENAL CAP SOFTGEL 10/31/2<strong>01</strong>3 2<strong>01</strong>2300642274690 RENAX TAB 2.5MG 12/31/9999 2<strong>01</strong>23630440622<strong>01</strong> RENO CAP 12/31/9999 2<strong>01</strong>2300062<strong>01</strong>8702 RENOVA CRE 0.02% 12/31/9999 2<strong>01</strong>2300062<strong>01</strong>8709 RENOVA CRE 0.02% 12/31/9999 2<strong>01</strong>2300062<strong>01</strong>8715 RENOVA PUMP CRE 0.02% 12/31/9999 2<strong>01</strong>2358468<strong>01</strong>32<strong>01</strong> RENVELA PAK 0.8GM 12/31/9999 2<strong>01</strong>2358468<strong>01</strong>3202 RENVELA PAK 0.8GM 12/31/9999 2<strong>01</strong>2358468<strong>01</strong>31<strong>01</strong> RENVELA PAK 2.4GM 12/31/9999 2<strong>01</strong>2358468<strong>01</strong>3102 RENVELA PAK 2.4GM 12/31/9999 2<strong>01</strong>2358468<strong>01</strong>30<strong>01</strong> RENVELA TAB 800MG 12/31/9999 2<strong>01</strong>23000027140<strong>01</strong> REOPRO INJ 2MG/ML 12/31/9999 2<strong>01</strong>2300642<strong>01</strong>6210 REPAN TAB 12/31/9999 2<strong>01</strong>23637170902<strong>01</strong> REPREXAIN TAB 10-200MG 02/28/2<strong>01</strong>4 2<strong>01</strong>23637170900<strong>01</strong> REPREXAIN TAB 2.5-200 05/31/2<strong>01</strong>3 2<strong>01</strong>236371709<strong>01</strong><strong>01</strong> REPREXAIN TAB 5-200MG <strong>01</strong>/31/2<strong>01</strong>4 2<strong>01</strong>23115280420<strong>01</strong> REPREXAIN TAB 7.5-200 12/31/9999 2<strong>01</strong>2355566718502 REPRONEX INJ 75UNIT 12/31/9999 2<strong>01</strong>23645430900<strong>01</strong> REQ 49+ TAB 12/31/9999 2<strong>01</strong>2300007489020 REQUIP TAB 0.25MG 12/31/9999 2<strong>01</strong>2300007489120 REQUIP TAB 0.5MG 12/31/9999 2<strong>01</strong>2300007489220 REQUIP TAB 1MG 12/31/9999 2<strong>01</strong>2300007489320 REQUIP TAB 2MG 12/31/9999 2<strong>01</strong>2300007489520 REQUIP TAB 3MG 12/31/9999 2<strong>01</strong>2300007489620 REQUIP TAB 4MG 12/31/9999 2<strong>01</strong>2300007489420 REQUIP TAB 5MG 12/31/9999 2<strong>01</strong>2300007488213 REQUIP XL TAB 12MG 12/31/9999 2<strong>01</strong>2300007488513 REQUIP XL TAB 2MG 12/31/9999 2<strong>01</strong>2300007488559 REQUIP XL TAB 2MG 12/31/9999 2<strong>01</strong>2300007488713 REQUIP XL TAB 4MG 12/31/9999 2<strong>01</strong>2300007488759 REQUIP XL TAB 4MG 12/31/9999 2<strong>01</strong>2300007488313 REQUIP XL TAB 6MG 12/31/9999 2<strong>01</strong>2300007488813 REQUIP XL TAB 8MG 12/31/9999 2<strong>01</strong>2300007488859 REQUIP XL TAB 8MG 12/31/9999 2<strong>01</strong>2364543009790 RESCON TAB 2-60MG 12/31/9999 2<strong>01</strong>2364543<strong>01</strong>0504 RESCON-DM SYP 12/31/9999 2<strong>01</strong>2364543<strong>01</strong>0516 RESCON-DM SYP 12/31/9999 2<strong>01</strong>2364543004404 RESCON-GG LIQ 12/31/9999 2<strong>01</strong>23

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