IOWA MEDICAID SUPPLEMENTAL DRUG REBATE AGREEMENTIowa Medicaid Supplemental Drug Rebate Agreement • December 11th, 2015 • Iowa
In consideration of the mutual covenants in this Agreement, including the General Supplemental Rebate Terms, Attachment A to this Agreement, and Attachment B to this Agreement, and for other good and valuable consideration, the receipt, adequacy and legal sufficiency of which are hereby acknowledged, the parties have entered into this Agreement and have caused their duly authorized representatives to execute this Agreement below.
IOWA MEDICAID SUPPLEMENTAL DRUG REBATE AGREEMENTIowa Medicaid Supplemental Drug Rebate Agreement • March 9th, 2021 • Iowa
Pharmaceutical Manufacturer (“Manufacturer”) Department of the State of Iowa (“Department”) Manufacturer Name Labeler Codes: Iowa Department of Human Services Manufacturer Primary Billing Address: Department Primary Billing Address: Iowa Medicaid Enterprise1305 East Walnut Street Des Moines, IA 50319-0114 Manufacturer Primary Contact Person: Department Primary Contact Person: Shari Martin Manufacturer Primary Contact Telephone: Department Primary Contact Telephone: 207-622-7153 EXT 71375 Manufacturer Primary Contact e-mail: Department Primary Contact e-mail: PBA_rxoffers@changehealthcare.com Address for Notices required by Agreement (“Manufacturer Notice Address”): Address for Notices required by Agreement: (“Department Notice Address”): Iowa Medicaid EnterpriseAttn: Susan Parker, Pharmacy Director 1305 East Walnut StreetDes Moines, IA 50319-0114 Termination Date: (“Termination Date”) Effective Date (“Effective Date”)
