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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51552048105 THIABENDAZOL POW 12/31/9999 2<strong>01</strong>23633230<strong>01</strong>302 THIAMINE HCL INJ 100MG/ML 12/31/9999 2<strong>01</strong>2367457<strong>01</strong>9602 THIAMINE HCL INJ 100MG/ML 12/31/9999 2<strong>01</strong>23005364680<strong>01</strong> THIAMINE HCL TAB 100MG 12/31/9999 2<strong>01</strong>2300536468<strong>01</strong>0 THIAMINE HCL TAB 100MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>780900<strong>01</strong> THIOLA TAB 100MG 12/31/9999 2<strong>01</strong>23003780618<strong>01</strong> THIORIDAZINE TAB 100MG 12/31/9999 2<strong>01</strong>2300378061810 THIORIDAZINE TAB 100MG 07/31/2<strong>01</strong>3 2<strong>01</strong>23510790580<strong>01</strong> THIORIDAZINE TAB 100MG 12/31/9999 2<strong>01</strong>2351079058020 THIORIDAZINE TAB 100MG 12/31/9999 2<strong>01</strong>23534890500<strong>01</strong> THIORIDAZINE TAB 100MG 12/31/9999 2<strong>01</strong>23003780612<strong>01</strong> THIORIDAZINE TAB 10MG 12/31/9999 2<strong>01</strong>23510790565<strong>01</strong> THIORIDAZINE TAB 10MG 12/31/9999 2<strong>01</strong>2351079056520 THIORIDAZINE TAB 10MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>48<strong>01</strong> THIORIDAZINE TAB 10MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>4810 THIORIDAZINE TAB 10MG 12/31/9999 2<strong>01</strong>23003780614<strong>01</strong> THIORIDAZINE TAB 25MG 12/31/9999 2<strong>01</strong>2300378061410 THIORIDAZINE TAB 25MG 07/13/2<strong>01</strong>3 2<strong>01</strong>23510790566<strong>01</strong> THIORIDAZINE TAB 25MG 12/31/9999 2<strong>01</strong>2351079056620 THIORIDAZINE TAB 25MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>49<strong>01</strong> THIORIDAZINE TAB 25MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>4910 THIORIDAZINE TAB 25MG 12/31/9999 2<strong>01</strong>23003780616<strong>01</strong> THIORIDAZINE TAB 50MG 12/31/9999 2<strong>01</strong>2300378061610 THIORIDAZINE TAB 50MG 07/31/2<strong>01</strong>3 2<strong>01</strong>23510790567<strong>01</strong> THIORIDAZINE TAB 50MG 12/31/9999 2<strong>01</strong>2351079056720 THIORIDAZINE TAB 50MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>50<strong>01</strong> THIORIDAZINE TAB 50MG 12/31/9999 2<strong>01</strong>2353489<strong>01</strong>5<strong>01</strong>0 THIORIDAZINE TAB 50MG 12/31/9999 2<strong>01</strong>2351552051206 THIOSULFATE CRY SODIUM 12/31/9999 2<strong>01</strong>2355390003<strong>01</strong>0 THIOTEPA INJ 15MG 12/31/9999 2<strong>01</strong>23003785<strong>01</strong>0<strong>01</strong> THIOTHIXENE CAP 10MG 12/31/9999 2<strong>01</strong>23007812229<strong>01</strong> THIOTHIXENE CAP 10MG 12/31/9999 2<strong>01</strong>23510790589<strong>01</strong> THIOTHIXENE CAP 10MG 12/31/9999 2<strong>01</strong>2351079058920 THIOTHIXENE CAP 10MG 12/31/9999 2<strong>01</strong>230037810<strong>01</strong><strong>01</strong> THIOTHIXENE CAP 1MG 12/31/9999 2<strong>01</strong>23007812226<strong>01</strong> THIOTHIXENE CAP 1MG 12/31/9999 2<strong>01</strong>23003782002<strong>01</strong> THIOTHIXENE CAP 2MG 12/31/9999 2<strong>01</strong>2300378200210 THIOTHIXENE CAP 2MG 11/30/2<strong>01</strong>2 2<strong>01</strong>23007812227<strong>01</strong> THIOTHIXENE CAP 2MG 12/31/9999 2<strong>01</strong>23510790587<strong>01</strong> THIOTHIXENE CAP 2MG 12/31/9999 2<strong>01</strong>2351079058720 THIOTHIXENE CAP 2MG 12/31/9999 2<strong>01</strong>23003783005<strong>01</strong> THIOTHIXENE CAP 5MG 12/31/9999 2<strong>01</strong>23007812228<strong>01</strong> THIOTHIXENE CAP 5MG 12/31/9999 2<strong>01</strong>23510790588<strong>01</strong> THIOTHIXENE CAP 5MG 12/31/9999 2<strong>01</strong>2351079058820 THIOTHIXENE CAP 5MG 12/31/9999 2<strong>01</strong>2300472145791 THIOTHIXENE CON 5MG/ML 12/31/9999 2<strong>01</strong>2300472145794 THIOTHIXENE CON 5MG/ML 12/31/9999 2<strong>01</strong>2351552074605 THREONINE POW 12/31/9999 2<strong>01</strong>2300067560511 THRIVE GUM 2MG MINT 12/31/9999 2<strong>01</strong>2300067560595 THRIVE GUM 2MG MINT 12/31/9999 2<strong>01</strong>2300067560611 THRIVE GUM 4MG MINT 12/31/9999 2<strong>01</strong>2300067560695 THRIVE GUM 4MG MINT 12/31/9999 2<strong>01</strong>2300904600505 THROAT LOZ 12/31/9999 2<strong>01</strong>2313533060320 THROMBAT III INJ 500UNIT 12/31/9999 2<strong>01</strong>2360793020505 THROMBIN KIT 5000UNIT 12/31/9999 2<strong>01</strong>2360793021721 THROMBIN-JMI KIT 20000UNT 12/31/9999 2<strong>01</strong>2360793021722 THROMBIN-JMI KIT 20000UNT 12/31/9999 2<strong>01</strong>2360793070505 THROMBIN-JMI KIT 5000UNIT 12/31/9999 2<strong>01</strong>2360793021720 THROMBIN-JMI SOL 20000UNT 12/31/9999 2<strong>01</strong>2360793021505 THROMBIN-JMI SOL 5000UNIT 12/31/9999 2<strong>01</strong>23

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