BETA-BLOCKERS | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
ACEBUTOLOL 200 MG CAPSULE acebutolol HCl	53746066901 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN KHC
ACEBUTOLOL 200 MG CAPSULE acebutolol HCl	62559025501 ANI PHARMACEUTI	No	No	Medicaid CHIP CSHCN
ACEBUTOLOL 400 MG CAPSULE acebutolol HCl	53746067001 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN KHC
ACEBUTOLOL 400 MG CAPSULE acebutolol HCl	62559025601 ANI PHARMACEUTI	No	No	Medicaid CHIP CSHCN
ATENOLOL 100 MG TABLET atenolol	63304062301 RANBAXY/SUN PHA	No	No	Medicaid CHIP CSHCN KHC
ATENOLOL 100 MG TABLET atenolol	68382002410 ZYDUS PHARMACEU	No	No	Medicaid CHIP CSHCN KHC
ATENOLOL 100 MG TABLET atenolol	65862017099 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN KHC
ATENOLOL 100 MG TABLET atenolol	63304062310 RANBAXY/SUN PHA	No	No	Medicaid CHIP CSHCN KHC
ATENOLOL 100 MG TABLET atenolol	51079068520 MYLAN INSTITUTI	No	No	Medicaid CHIP CSHCN
ATENOLOL 100 MG TABLET atenolol	00378075701 MYLAN	No	No	Medicaid CHIP CSHCN KHC