BPH TREATMENTS | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	13668002101 TORRENT PHARMAC	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	69097084407 CIPLA USA, INC.	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	13668002105 TORRENT PHARMAC	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	69097084412 CIPLA USA, INC.	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	29300015501 UNICHEM PHARMAC	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	29300015519 UNICHEM PHARMAC	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	57237011490 RISING PHARM	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	47335095618 SUN PHARMA GLOB	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	60505285001 APOTEX CORP	No	No	Medicaid CHIP CSHCN
ALFUZOSIN HCL ER 10 MG TABLET alfuzosin HCl	76282030201 EXELAN PHARMACE	No	No	Medicaid CHIP CSHCN