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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003783242<strong>01</strong> TRANDOLAPRIL TAB 2MG 11/30/2<strong>01</strong>2 2<strong>01</strong>2316252054290 TRANDOLAPRIL TAB 2MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>65<strong>01</strong> TRANDOLAPRIL TAB 2MG 12/31/9999 2<strong>01</strong>23681800567<strong>01</strong> TRANDOLAPRIL TAB 2MG 12/31/9999 2<strong>01</strong>23000937327<strong>01</strong> TRANDOLAPRIL TAB 4MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>439127<strong>01</strong> TRANDOLAPRIL TAB 4MG 12/31/9999 2<strong>01</strong>23003783243<strong>01</strong> TRANDOLAPRIL TAB 4MG 12/31/9999 2<strong>01</strong>2316252054390 TRANDOLAPRIL TAB 4MG 12/31/9999 2<strong>01</strong>2365862<strong>01</strong>66<strong>01</strong> TRANDOLAPRIL TAB 4MG 12/31/9999 2<strong>01</strong>23681800568<strong>01</strong> TRANDOLAPRIL TAB 4MG 12/31/9999 2<strong>01</strong>2300517096<strong>01</strong>0 TRANEXAMIC INJ ACID 12/31/9999 2<strong>01</strong>2363323056397 TRANEXAMIC INJ ACID 12/31/9999 2<strong>01</strong>2367457<strong>01</strong>9710 TRANEXAMIC INJ ACID 12/31/9999 2<strong>01</strong>2300067434504 TRANSDERM-SC DIS 1.5MG 12/31/9999 2<strong>01</strong>2310<strong>01</strong>90553<strong>01</strong> TRANSDERM-SC DIS 1.5MG 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9055302 TRANSDERM-SC DIS 1.5MG 12/31/9999 2<strong>01</strong>2310<strong>01</strong>9055388 TRANSDERM-SC DIS 1.5MG 12/31/9999 2<strong>01</strong>231033702<strong>01</strong>06 TRANS-VER-SA DIS 15% 12/31/9999 2<strong>01</strong>231033702<strong>01</strong>15 TRANS-VER-SA DIS 15% 12/31/9999 2<strong>01</strong>2310337020203 TRANS-VER-SA DIS 15% 12/31/9999 2<strong>01</strong>2310337020206 TRANS-VER-SA DIS 15% 12/31/9999 2<strong>01</strong>2310337020302 TRANS-VER-SA DIS 15% 12/31/9999 2<strong>01</strong>23673860303<strong>01</strong> TRANXENE T TAB 15MG 12/31/9999 2<strong>01</strong>236738603<strong>01</strong><strong>01</strong> TRANXENE T TAB 3.75MG 12/31/9999 2<strong>01</strong>23673860302<strong>01</strong> TRANXENE T TAB 7.5MG 12/31/9999 2<strong>01</strong>23498840032<strong>01</strong> TRANYLCYPROM TAB 10MG 12/31/9999 2<strong>01</strong>2300338064403 TRAVASOL INJ 10% 12/31/9999 2<strong>01</strong>2300338064404 TRAVASOL INJ 10% 12/31/9999 2<strong>01</strong>2300338064406 TRAVASOL INJ 10% 12/31/9999 2<strong>01</strong>2300065026005 TRAVATAN Z DRO 0.004% 12/31/9999 2<strong>01</strong>2300065026025 TRAVATAN Z DRO 0.004% 12/31/9999 2<strong>01</strong>23005363990<strong>01</strong> TRAVEL SICK CHW 25MG 12/31/9999 2<strong>01</strong>2300536399<strong>01</strong>0 TRAVEL SICK CHW 25MG 12/31/9999 2<strong>01</strong>2363868<strong>01</strong>6<strong>01</strong>2 TRAVEL SICK TAB 50MG 12/31/9999 2<strong>01</strong>2368405800306 TRAZAMINE PAK 12/31/9999 2<strong>01</strong>230<strong>01</strong>82126000 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>82126089 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>23003783472<strong>01</strong> TRAZODONE TAB 100MG 05/31/2<strong>01</strong>3 2<strong>01</strong>2300378347210 TRAZODONE TAB 100MG <strong>01</strong>/31/2<strong>01</strong>3 2<strong>01</strong>2300603616102 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300603616104 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300603616116 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300603616120 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300603616121 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300603616128 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300603616132 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2300904399161 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>235<strong>01</strong>110434<strong>01</strong> TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>235<strong>01</strong>11043402 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>235<strong>01</strong>11043403 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>23534890511<strong>01</strong> TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2360505265400 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>23605052654<strong>01</strong> TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2360505265405 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2360505265407 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>2360505292107 TRAZODONE TAB 100MG 12/31/9999 2<strong>01</strong>23003783473<strong>01</strong> TRAZODONE TAB 150MG 05/31/2<strong>01</strong>3 2<strong>01</strong>2300378347310 TRAZODONE TAB 150MG 05/31/2<strong>01</strong>3 2<strong>01</strong>235<strong>01</strong>110441<strong>01</strong> TRAZODONE TAB 150MG 12/31/9999 2<strong>01</strong>235<strong>01</strong>11044102 TRAZODONE TAB 150MG 12/31/9999 2<strong>01</strong>23

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