ANGIOTENSIN MODULATORS | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	43547033610 SOLCO HEALTHCAR	No	No	Medicaid CHIP CSHCN HTW
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	65862011601 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN HTW KHC
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	43547033650 SOLCO HEALTHCAR	No	No	Medicaid CHIP CSHCN HTW
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	53746075201 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN KHC
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	53746075205 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN KHC
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	65162075210 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN HTW KHC
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	65162075250 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN HTW KHC
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	23155075001 AVET PHARMACEUT	No	No	Medicaid CHIP CSHCN
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	62135072090 CHARTWELL RX LL	No	No	Medicaid CHIP CSHCN
BENAZEPRIL HCL 10 MG TABLET benazepril HCl	23155075005 AVET PHARMACEUT	No	No	Medicaid CHIP CSHCN