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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52152003205 YOHIMBINE TAB 5.4MG 12/31/9999 2<strong>01</strong>2300078047641 ZADITOR DRO 0.025%OP 11/30/2<strong>01</strong>3 2<strong>01</strong>2300078047661 ZADITOR DRO 0.025%OP 05/31/2<strong>01</strong>4 2<strong>01</strong>2300310041160 ZAFIRLUKAST TAB 10MG 12/31/9999 2<strong>01</strong>2349884030302 ZAFIRLUKAST TAB 10MG 12/31/9999 2<strong>01</strong>2355111062560 ZAFIRLUKAST TAB 10MG 12/31/9999 2<strong>01</strong>2300310041260 ZAFIRLUKAST TAB 20MG 12/31/9999 2<strong>01</strong>2349884030402 ZAFIRLUKAST TAB 20MG 12/31/9999 2<strong>01</strong>2355111062660 ZAFIRLUKAST TAB 20MG 12/31/9999 2<strong>01</strong>2300054008525 ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>23000935269<strong>01</strong> ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>433910<strong>01</strong> ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>23003786810<strong>01</strong> ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>2316714056102 ZALEPLON CAP 10MG 12/31/2020 2<strong>01</strong>2329300<strong>01</strong>32<strong>01</strong> ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>23597622631<strong>01</strong> ZALEPLON CAP 10MG 03/31/2<strong>01</strong>3 2<strong>01</strong>2364720032310 ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>23658620215<strong>01</strong> ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>23678770211<strong>01</strong> ZALEPLON CAP 10MG 12/31/9999 2<strong>01</strong>2300054008425 ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>23000935268<strong>01</strong> ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>433909<strong>01</strong> ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>23003786805<strong>01</strong> ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>2316714055102 ZALEPLON CAP 5MG 12/31/2020 2<strong>01</strong>2329300<strong>01</strong>31<strong>01</strong> ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>23597622630<strong>01</strong> ZALEPLON CAP 5MG 11/30/2<strong>01</strong>2 2<strong>01</strong>2359762263004 ZALEPLON CAP 5MG 11/30/2<strong>01</strong>2 2<strong>01</strong>2364720032210 ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>23658620214<strong>01</strong> ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>23678770210<strong>01</strong> ZALEPLON CAP 5MG 12/31/9999 2<strong>01</strong>23000245840<strong>01</strong> ZALTRAP INJ 100/4ML 12/31/9999 2<strong>01</strong>23000245841<strong>01</strong> ZALTRAP INJ 200/8ML 12/31/9999 2<strong>01</strong>2363717089516 ZAMICET SOL 10-325MG 12/31/9999 2<strong>01</strong>231<strong>01</strong>44060215 ZANAFLEX CAP 2MG 12/31/9999 2<strong>01</strong>231<strong>01</strong>44060415 ZANAFLEX CAP 4MG 12/31/9999 2<strong>01</strong>231<strong>01</strong>44060615 ZANAFLEX CAP 6MG 12/31/9999 2<strong>01</strong>231<strong>01</strong>44059415 ZANAFLEX TAB 4MG 12/31/9999 2<strong>01</strong>23007034636<strong>01</strong> ZANOSAR INJ 1GM 12/31/9999 2<strong>01</strong>230<strong>01</strong>73036238 ZANTAC INJ 25MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>73036300 ZANTAC INJ 25MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>730363<strong>01</strong> ZANTAC INJ 25MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>73044100 ZANTAC INJ 50/50ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>73038354 ZANTAC SYP 15MG/ML 12/31/9999 2<strong>01</strong>230<strong>01</strong>73034414 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>73034442 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2024 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2050 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2068 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2124 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2150 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2168 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2190 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2195 ZANTAC TAB 150MG 12/31/9999 2<strong>01</strong>230<strong>01</strong>73073400 ZANTAC TAB 25MG EF 12/31/9999 2<strong>01</strong>230<strong>01</strong>73039340 ZANTAC TAB 300MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2213 ZANTAC TAB 75MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2227 ZANTAC TAB 75MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2237 ZANTAC TAB 75MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2254 ZANTAC TAB 75MG 12/31/9999 2<strong>01</strong>2300597<strong>01</strong>2281 ZANTAC TAB 75MG 12/31/9999 2<strong>01</strong>23

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