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

60793010401 TAPAZOLE TAB 5MG 12/31/9999 2012350242006301 TARCEVA TAB 100MG 12/31/9999 2012350242006401 TARCEVA TAB 150MG 12/31/9999 2012350242006201 TARCEVA TAB 25MG 12/31/9999 2012362856060210 TARGRETIN CAP 75MG 12/31/9999 2012362856060422 TARGRETIN GEL 1% 12/31/9999 2012300074328813 TARKA TAB 1-240 CR 12/31/9999 2012300074328713 TARKA TAB 2-180 CR 12/31/9999 2012300074328913 TARKA TAB 2-240 CR 12/31/9999 2012300074329013 TARKA TAB 4-240 CR 12/31/9999 2012313811054230 TARON A PAK 12/31/9999 2012313811004210 TARON FORTE CAP 12/31/9999 2012313811056930 TARON-BC MIS 12/31/9999 2012313811053630 TARON-C DHA CAP 12/31/9999 2012313811059230 TARON-DUO EC PAK 12/31/9999 2012313811054330 TARON-PREX CAP 12/31/9999 2012300078059251 TASIGNA CAP 150MG 12/31/9999 2012300078059287 TASIGNA CAP 150MG 12/31/9999 2012300078052651 TASIGNA CAP 200MG 12/31/9999 2012300078052687 TASIGNA CAP 200MG 12/31/9999 2012300187093801 TASMAR TAB 100MG 12/31/9999 2012300067119008 TAVIST TAB 1.34MG 12/31/9999 2012300067119016 TAVIST TAB 1.34MG 12/31/9999 2012300075800301 TAXOTERE INJ 20MG/ML 12/31/9999 2012300075800180 TAXOTERE INJ 80MG/2ML 06/30/2013 2012300075800404 TAXOTERE INJ 80MG/4ML 12/31/9999 2012300409508216 TAZICEF INJ 1GM 12/31/9999 2012300409508252 TAZICEF INJ 1GM 12/31/9999 2012300409509216 TAZICEF INJ 1GM 12/31/9999 2012300409509252 TAZICEF INJ 1GM 12/31/9999 2012300409508411 TAZICEF INJ 2GM 12/31/9999 2012300409508451 TAZICEF INJ 2GM 12/31/9999 2012300409509311 TAZICEF INJ 2GM 12/31/9999 2012300409509351 TAZICEF INJ 2GM 12/31/9999 2012300409508611 TAZICEF INJ 6GM 12/31/9999 2012300409508651 TAZICEF INJ 6GM 12/31/9999 2012300023915530 TAZORAC CRE 0.05% 12/31/9999 2012300023915560 TAZORAC CRE 0.05% 12/31/9999 2012300023915630 TAZORAC CRE 0.1% 12/31/9999 2012300023915660 TAZORAC CRE 0.1% 12/31/9999 2012300023833503 TAZORAC GEL 0.05% 12/31/9999 2012300023833510 TAZORAC GEL 0.05% 12/31/9999 2012300023004203 TAZORAC GEL 0.1% 12/31/9999 2012300023004210 TAZORAC GEL 0.1% 12/31/9999 2012362037069630 TAZTIA XT CAP 120MG/24 12/31/9999 2012362037069690 TAZTIA XT CAP 120MG/24 12/31/9999 2012362037069730 TAZTIA XT CAP 180MG/24 12/31/9999 2012362037069790 TAZTIA XT CAP 180MG/24 12/31/9999 2012362037069830 TAZTIA XT CAP 240MG/24 12/31/9999 2012362037069890 TAZTIA XT CAP 240MG/24 12/31/9999 2012362037069930 TAZTIA XT CAP 300MG/24 12/31/9999 2012362037069990 TAZTIA XT CAP 300MG/24 12/31/9999 2012362037070030 TAZTIA XT CAP 360MG/24 12/31/9999 2012362037070090 TAZTIA XT CAP 360MG/24 12/31/9999 2012300065042615 TEARS NATURA SOL FORTE 12/31/9999 2012300065042622 TEARS NATURA SOL FORTE 12/31/9999 2012300065042623 TEARS NATURA SOL FORTE 12/31/9999 2012300065042630 TEARS NATURA SOL FORTE 12/31/9999 2012300998041315 TEARS NATURA SOL FORTE 12/31/9999 2012300998041330 TEARS NATURA SOL FORTE 12/31/9999 20123