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

00555188302 BENZONATATE CAP 200MG 12/31/9999 2012300904625460 BENZONATATE CAP 200MG 12/31/9999 2012357664013488 BENZONATATE CAP 200MG 12/31/9999 2012365162053710 BENZONATATE CAP 200MG 12/31/9999 2012365162053750 BENZONATATE CAP 200MG 12/31/9999 2012367877010601 BENZONATATE CAP 200MG 12/31/9999 2012367877010605 BENZONATATE CAP 200MG 12/31/9999 2012368382024801 BENZONATATE CAP 200MG 12/31/9999 2012345802030801 BENZOYL PER GEL 10% 12/31/9999 2012345802030896 BENZOYL PER GEL 10% 12/31/9999 2012345802091596 BENZOYL PER GEL 10% 02/01/2014 2012345802010196 BENZOYL PER GEL 2.5% 12/31/9999 2012345802090596 BENZOYL PER GEL 2.5% 02/02/2013 2012300536408956 BENZOYL PER GEL 5% 12/31/9999 2012345802021601 BENZOYL PER GEL 5% 12/31/9999 2012345802021696 BENZOYL PER GEL 5% 12/31/9999 2012345802091001 BENZOYL PER GEL 5% 02/01/2014 2012345802091096 BENZOYL PER GEL 5% 12/31/9999 2012368462054838 BENZOYL PER KIT 4% WASH 12/31/9999 2012368462054938 BENZOYL PER KIT 8% WASH 12/31/9999 2012345802091801 BENZOYL PER LIQ 10% WASH 02/01/2013 2012345802091834 BENZOYL PER LIQ 10% WASH 03/01/2013 2012367405083005 BENZOYL PER LIQ 10% WASH 12/31/9999 2012367405083008 BENZOYL PER LIQ 10% WASH 12/31/9999 2012345802090734 BENZOYL PER LIQ 2.5%WASH 12/31/9999 2012368462041438 BENZOYL PER LIQ 4% CREM 12/31/9999 2012345802091301 BENZOYL PER LIQ 5% WASH 01/01/2013 2012345802091334 BENZOYL PER LIQ 5% WASH 12/31/9999 2012367405042505 BENZOYL PER LIQ 5% WASH 12/31/2012 2012367405042508 BENZOYL PER LIQ 5% WASH 11/30/2012 2012367405082505 BENZOYL PER LIQ 5% WASH 12/31/9999 2012367405082508 BENZOYL PER LIQ 5% WASH 12/31/9999 2012368462041538 BENZOYL PER LIQ 8% CREM 12/31/9999 2012300536081595 BENZOYL PER LOT 10% 12/31/9999 2012368462041134 BENZOYL PER LOT 3% 12/31/9999 2012368462041138 BENZOYL PER LOT 3% 12/31/9999 2012300536081095 BENZOYL PER LOT 5% 12/31/9999 2012367405083506 BENZOYL PER LOT 6% 12/31/9999 2012367405083512 BENZOYL PER LOT 6% 12/31/9999 2012368462041234 BENZOYL PER LOT 6% 12/31/9999 2012368462041238 BENZOYL PER LOT 6% 12/31/9999 2012368462041334 BENZOYL PER LOT 9% 12/31/9999 2012368462041338 BENZOYL PER LOT 9% 12/31/9999 2012351552052104 BENZOYL PER POW HYDROUS 12/31/9999 2012351552052106 BENZOYL PER POW HYDROUS 12/31/9999 2012351552052109 BENZOYL PER POW HYDROUS 12/31/9999 2012310702004001 BENZPHETAMIN TAB 50MG 12/31/9999 2012310702004003 BENZPHETAMIN TAB 50MG 12/31/9999 2012310702004050 BENZPHETAMIN TAB 50MG 12/31/9999 2012343547026310 BENZPHETAMIN TAB 50MG 12/31/9999 2012364376065001 BENZPHETAMIN TAB 50MG 12/31/9999 2012364376065005 BENZPHETAMIN TAB 50MG 12/31/9999 2012364376065031 BENZPHETAMIN TAB 50MG 12/31/9999 2012364376065090 BENZPHETAMIN TAB 50MG 12/31/9999 2012300143972905 BENZTROPINE INJ 1MG/ML 12/31/9999 2012300517078505 BENZTROPINE INJ 1MG/ML 12/31/9999 2012300603243321 BENZTROPINE TAB 0.5MG 12/31/9999 2012300603243332 BENZTROPINE TAB 0.5MG 12/31/9999 2012300832108000 BENZTROPINE TAB 0.5MG 12/31/9999 2012300904105560 BENZTROPINE TAB 0.5MG 12/31/9999 20123