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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51552116806 BUMM BALM OIN 9.38% 12/31/9999 2<strong>01</strong>2351552116809 BUMM BALM OIN 9.38% 12/31/9999 2<strong>01</strong>23000950240<strong>01</strong> BUPAP TAB 50-650MG 12/31/9999 2<strong>01</strong>2362592<strong>01</strong>8864 BUPHENYL POW 12/31/9999 2<strong>01</strong>2362592049603 BUPHENYL TAB 500MG 12/31/9999 2<strong>01</strong>23004091158<strong>01</strong> BUPIVACAINE INJ 0.25% 12/31/9999 2<strong>01</strong>23004091159<strong>01</strong> BUPIVACAINE INJ 0.25% 12/31/9999 2<strong>01</strong>2300409115902 BUPIVACAINE INJ 0.25% 12/31/9999 2<strong>01</strong>23004091160<strong>01</strong> BUPIVACAINE INJ 0.25% 12/31/9999 2<strong>01</strong>23004094272<strong>01</strong> BUPIVACAINE INJ 0.25% 12/31/9999 2<strong>01</strong>23004091161<strong>01</strong> BUPIVACAINE INJ 0.5% 12/31/9999 2<strong>01</strong>23004091162<strong>01</strong> BUPIVACAINE INJ 0.5% 12/31/9999 2<strong>01</strong>2300409116202 BUPIVACAINE INJ 0.5% 12/31/9999 2<strong>01</strong>23004091163<strong>01</strong> BUPIVACAINE INJ 0.5% 12/31/9999 2<strong>01</strong>23004094273<strong>01</strong> BUPIVACAINE INJ 0.5% 12/31/9999 2<strong>01</strong>23004095757<strong>01</strong> BUPIVACAINE INJ 0.5% 12/31/9999 2<strong>01</strong>23004091165<strong>01</strong> BUPIVACAINE INJ 0.75% 12/31/9999 2<strong>01</strong>2300409116502 BUPIVACAINE INJ 0.75% 12/31/9999 2<strong>01</strong>23004093613<strong>01</strong> BUPIVACAINE INJ SPINAL 12/31/9999 2<strong>01</strong>23004099042<strong>01</strong> BUPIVACAINE/ INJ EPI 0.25 12/31/9999 2<strong>01</strong>2300409904217 BUPIVACAINE/ INJ EPI 0.25 12/31/9999 2<strong>01</strong>23004099043<strong>01</strong> BUPIVACAINE/ INJ EPI 0.25 12/31/9999 2<strong>01</strong>23004097600<strong>01</strong> BUPIVACAINE/ INJ EPI 0.5% 12/31/9999 2<strong>01</strong>23004099045<strong>01</strong> BUPIVACAINE/ INJ EPI 0.5% 12/31/9999 2<strong>01</strong>2300409904517 BUPIVACAINE/ INJ EPI 0.5% 12/31/9999 2<strong>01</strong>23004099046<strong>01</strong> BUPIVACAINE/ INJ EPI 0.5% 12/31/9999 2<strong>01</strong>23124960757<strong>01</strong> BUPRENEX INJ 0.3MG/ML 12/31/9999 2<strong>01</strong>23004092<strong>01</strong>232 BUPRENORPHIN INJ 0.3MG/ML 12/31/9999 2<strong>01</strong>2355390<strong>01</strong>0<strong>01</strong>0 BUPRENORPHIN INJ 0.3MG/ML 12/31/9999 2<strong>01</strong>2300054<strong>01</strong>7613 BUPRENORPHIN SUB 2MG 12/31/9999 2<strong>01</strong>2300093537856 BUPRENORPHIN SUB 2MG 12/31/9999 2<strong>01</strong>2350383092493 BUPRENORPHIN SUB 2MG 12/31/9999 2<strong>01</strong>2300054<strong>01</strong>7713 BUPRENORPHIN SUB 8MG 12/31/9999 2<strong>01</strong>2300093537956 BUPRENORPHIN SUB 8MG 12/31/9999 2<strong>01</strong>2350383093093 BUPRENORPHIN SUB 8MG 12/31/9999 2<strong>01</strong>2368308020830 BUPRENORPHIN SUB 8MG 12/31/9999 2<strong>01</strong>23000935703<strong>01</strong> BUPROBAN TAB 150MG 12/31/9999 2<strong>01</strong>23003780435<strong>01</strong> BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2300378043505 BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>23007811064<strong>01</strong> BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2300781106410 BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2300904612961 BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>23510790944<strong>01</strong> BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2351079094420 BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2360505<strong>01</strong>57<strong>01</strong> BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2360505<strong>01</strong>5705 BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2360505<strong>01</strong>5709 BUPROPION TAB 100MG 12/31/9999 2<strong>01</strong>2310370<strong>01</strong>5906 BUPROPION TAB 100MG ER 12/31/9999 2<strong>01</strong>23167140334<strong>01</strong> BUPROPION TAB 100MG ER 12/31/2020 2<strong>01</strong>2316714033402 BUPROPION TAB 100MG ER 12/31/2020 2<strong>01</strong>2316714033403 BUPROPION TAB 100MG ER 12/31/2020 2<strong>01</strong>2364679<strong>01</strong><strong>01</strong>02 BUPROPION TAB 100MG ER 12/31/9999 2<strong>01</strong>2364679<strong>01</strong><strong>01</strong>03 BUPROPION TAB 100MG ER 12/31/9999 2<strong>01</strong>2367767<strong>01</strong>7160 BUPROPION TAB 100MG ER 12/31/9999 2<strong>01</strong>230<strong>01</strong>850410<strong>01</strong> BUPROPION TAB 100MG SR 12/31/9999 2<strong>01</strong>230<strong>01</strong>85041005 BUPROPION TAB 100MG SR 12/31/9999 2<strong>01</strong>230<strong>01</strong>85041060 BUPROPION TAB 100MG SR 12/31/9999 2<strong>01</strong>23003783411<strong>01</strong> BUPROPION TAB 100MG SR 12/31/9999 2<strong>01</strong>2300378341105 BUPROPION TAB 100MG SR 12/31/9999 2<strong>01</strong>2300591354005 BUPROPION TAB 100MG SR 12/31/9999 2<strong>01</strong>23

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