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

64543004416 RESCON-GG LIQ 12/31/9999 2012349702020924 RESCRIPTOR TAB 100 MG 12/31/9999 2012349702021017 RESCRIPTOR TAB 200MG 12/31/2016 2012363010002118 RESCRIPTOR TAB 200MG 08/31/2015 2012300264230350 RESECTISOL SOL 5% 12/31/9999 2012338779015901 RESERPINE POW 12/31/9999 2012338779015903 RESERPINE POW 12/31/9999 2012338779015904 RESERPINE POW 12/31/9999 2012338779015906 RESERPINE POW 12/31/9999 2012300185003201 RESERPINE TAB 0.1MG 12/31/9999 2012300185003210 RESERPINE TAB 0.1MG 12/31/9999 2012300185013401 RESERPINE TAB 0.25MG 12/31/9999 2012300185013410 RESERPINE TAB 0.25MG 12/31/9999 2012360575053119 RESPA C&C TAB 12/31/9999 2012360575017719 RESPA-A.R. TAB 12/31/9999 2012316477030601 RESPAIRE-30 CAP 12/31/9999 2012363868078924 REST SIMPLY TAB 25MG 12/31/9999 2012300023916330 RESTASIS EMU 0.05% 12/31/9999 2012300023916360 RESTASIS EMU 0.05% 12/31/9999 2012337205019462 RESTFULLY SL TAB 25MG 12/31/9999 2012352747020030 RESTORA CAP 12/31/9999 2012300406991601 RESTORIL CAP 15MG 12/31/9999 2012300406991605 RESTORIL CAP 15MG 12/31/9999 2012300406991403 RESTORIL CAP 22.5MG 12/31/9999 2012300406991701 RESTORIL CAP 30MG 12/31/9999 2012300406991705 RESTORIL CAP 30MG 12/31/9999 2012300406991501 RESTORIL CAP 7.5MG 12/31/9999 2012300406991503 RESTORIL CAP 7.5MG 12/31/9999 2012300062016501 RETIN-A CRE 0.025% 12/31/9999 2012300062016502 RETIN-A CRE 0.025% 12/31/9999 2012300062017512 RETIN-A CRE 0.05% 12/31/9999 2012300062017513 RETIN-A CRE 0.05% 12/31/9999 2012300062027501 RETIN-A CRE 0.1% 12/31/9999 2012300062027523 RETIN-A CRE 0.1% 12/31/9999 2012300062057544 RETIN-A GEL 0.01% 12/31/9999 2012300062057546 RETIN-A GEL 0.01% 12/31/9999 2012300062047542 RETIN-A GEL 0.025% 12/31/9999 2012300062047545 RETIN-A GEL 0.025% 12/31/9999 2012300062020402 RETIN-A MICR GEL 0.04% 12/31/9999 2012300062020403 RETIN-A MICR GEL 0.04% 12/31/9999 2012300062020411 RETIN-A MICR GEL 0.04%PMP 12/31/9999 2012300062019002 RETIN-A MICR GEL 0.1% 12/31/9999 2012300062019003 RETIN-A MICR GEL 0.1% 12/31/9999 2012300062019011 RETIN-A MICR GEL 0.1%PUMP 12/31/9999 2012324208041601 RETISERT IMP 0.59MG 12/31/9999 2012300173010855 RETROVIR CAP 100MG 06/30/2013 2012349702021120 RETROVIR CAP 100MG 12/31/9999 2012300173010793 RETROVIR INJ 10MG/ML 05/31/2013 2012349702021305 RETROVIR INJ 10MG/ML 12/31/9999 2012300173011318 RETROVIR SYP 50MG/5ML 09/30/2013 2012349702021248 RETROVIR SYP 50MG/5ML 12/31/9999 2012300173050100 RETROVIR TAB 300MG 03/14/2013 2012349702021418 RETROVIR TAB 300MG 02/08/2015 2012300069033801 REVATIO INJ 12/31/9999 2012300069419068 REVATIO TAB 20MG 12/31/9999 2012351285027501 REVIA TAB 50MG 12/31/9999 2012359572041000 REVLIMID CAP 10MG 12/31/9999 2012359572041028 REVLIMID CAP 10MG 12/31/9999 2012359572041500 REVLIMID CAP 15MG 12/31/9999 2012359572041521 REVLIMID CAP 15MG 12/31/9999 20123