ANGIOTENSIN MODULATORS | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	65162075310 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN HTW KHC
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	65162075350 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN HTW KHC
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	62135072190 CHARTWELL RX LL	No	No	Medicaid CHIP CSHCN
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	65862011701 AUROBINDO PHARM	No	No	Medicaid CHIP CSHCN HTW KHC
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	43547033710 SOLCO HEALTHCAR	No	No	Medicaid CHIP CSHCN HTW
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	43547033750 SOLCO HEALTHCAR	No	No	Medicaid CHIP CSHCN HTW
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	23155075101 AVET PHARMACEUT	No	No	Medicaid CHIP CSHCN
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	23155075105 AVET PHARMACEUT	No	No	Medicaid CHIP CSHCN
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	53746075301 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN KHC
BENAZEPRIL HCL 20 MG TABLET benazepril HCl	53746075305 AMNEAL PHARMACE	No	No	Medicaid CHIP CSHCN KHC