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

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

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007811684<strong>01</strong> CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2300904585261 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2300904610061 CETIRIZINE TAB 10MG 08/31/2<strong>01</strong>3 2<strong>01</strong>2316571040210 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2316571040290 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2316714027102 CETIRIZINE TAB 10MG 12/31/2020 2<strong>01</strong>2316714027103 CETIRIZINE TAB 10MG 12/31/2020 2<strong>01</strong>2345802091939 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2345802091987 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>23510790597<strong>01</strong> CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2351079059720 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2351660093830 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2351660093854 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2351660093890 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2355111035190 CETIRIZINE TAB 10MG 06/30/2<strong>01</strong>3 2<strong>01</strong>2355111069990 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>23605052633<strong>01</strong> CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>2360505263308 CETIRIZINE TAB 10MG 12/31/9999 2<strong>01</strong>23003783635<strong>01</strong> CETIRIZINE TAB 5MG 12/31/9999 2<strong>01</strong>23007811683<strong>01</strong> CETIRIZINE TAB 5MG 12/31/9999 2<strong>01</strong>231657104<strong>01</strong>10 CETIRIZINE TAB 5MG 12/31/9999 2<strong>01</strong>23605052632<strong>01</strong> CETIRIZINE TAB 5MG 12/31/9999 2<strong>01</strong>2366992045<strong>01</strong>4 CETRAXAL SOL 0.2% 05/<strong>01</strong>/2020 2<strong>01</strong>23440871225<strong>01</strong> CETROTIDE KIT 0.25MG 12/31/9999 2<strong>01</strong>23440871203<strong>01</strong> CETROTIDE KIT 3MG 12/31/9999 2<strong>01</strong>2351552022705 CETYL ALCOHO GRA 12/31/9999 2<strong>01</strong>2351552022706 CETYL ALCOHO GRA 12/31/9999 2<strong>01</strong>2351552022708 CETYL ALCOHO GRA 12/31/9999 2<strong>01</strong>2338779061805 CETYL ALCOHO POW 12/31/9999 2<strong>01</strong>2338779061808 CETYL ALCOHO POW 12/31/9999 2<strong>01</strong>2338779061809 CETYL ALCOHO POW 12/31/9999 2<strong>01</strong>23633040479<strong>01</strong> CEVIMELINE CAP 30MG 12/31/9999 2<strong>01</strong>2300069047102 CHANTIX PAK 0.5& 1MG 12/31/9999 2<strong>01</strong>2300069047197 CHANTIX PAK 0.5& 1MG 12/31/9999 2<strong>01</strong>2300069046912 CHANTIX PAK 1MG 12/31/9999 2<strong>01</strong>2300069046997 CHANTIX PAK 1MG 12/31/9999 2<strong>01</strong>2300069046856 CHANTIX TAB 0.5MG 12/31/9999 2<strong>01</strong>2300069046956 CHANTIX TAB 1MG 12/31/9999 2<strong>01</strong>2351552063209 CHEESE LIQ FLAVOR 12/31/9999 2<strong>01</strong>23005366671<strong>01</strong> CHELATED ZN TAB 50MG 12/31/9999 2<strong>01</strong>236738602<strong>01</strong>11 CHEMET CAP 100MG 12/31/9999 2<strong>01</strong>2345043087640 CHENODAL TAB 250MG 12/31/9999 2<strong>01</strong>2300603107858 CHERATUSSIN SOL DAC 12/31/9999 2<strong>01</strong>2300603107554 CHERATUSSIN SYP AC 12/31/9999 2<strong>01</strong>2300603107556 CHERATUSSIN SYP AC 12/31/9999 2<strong>01</strong>2300603107558 CHERATUSSIN SYP AC 12/31/9999 2<strong>01</strong>2351552117704 CHERRY POW FLAVOR 12/31/9999 2<strong>01</strong>2351552117706 CHERRY POW FLAVOR 12/31/9999 2<strong>01</strong>2300228123316 CHERRY SYP 12/31/9999 2<strong>01</strong>2351552029003 CHERRY SYP CONCENTR 12/31/9999 2<strong>01</strong>2337205053871 CHEST CONGES TAB 20-400MG 12/31/9999 2<strong>01</strong>2349348072809 CHEST CONGES TAB 20-400MG 12/31/9999 2<strong>01</strong>2337205047671 CHEST CONGES TAB 400MG 12/31/9999 2<strong>01</strong>2349614044871 CHEST CONGES TAB 400MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10060<strong>01</strong> CHEST CONGES TAB 400MG 12/31/9999 2<strong>01</strong>2362<strong>01</strong>10061<strong>01</strong> CHEST CONGES TAB RELF DM 12/31/9999 2<strong>01</strong>2349348072909 CHEST CONGES TAB RELIEF 12/31/9999 2<strong>01</strong>2337205087471 CHEST CONGST TAB RLF PE 12/31/9999 2<strong>01</strong>2349348077409 CHEST CONGST TAB RLF PE 12/31/9999 2<strong>01</strong>2351552056906 CHICKEN LIQ FLAVOR 12/31/9999 2<strong>01</strong>23

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