LIPOTROPICS: STATINS | Vendor Drug Program

Brand Name/Generic Name	NDC/Manufacturer	FFS Clinical Prior Auth Required	PDL Prior Auth Required	Programs
ATORVASTATIN 10 MG TABLET atorvastatin calcium	82009000190 QUALLENT PHARMA	Yes	No	Medicaid CHIP CSHCN
ATORVASTATIN 10 MG TABLET atorvastatin calcium	60505257808 APOTEX CORP	Yes	No	Medicaid CHIP CSHCN HTW KHC
ATORVASTATIN 10 MG TABLET atorvastatin calcium	55111012105 DR.REDDY'S LAB	Yes	No	Medicaid CHIP CSHCN HTW KHC
ATORVASTATIN 10 MG TABLET atorvastatin calcium	00904629061 MAJOR PHARMACEU	Yes	No	Medicaid CHIP CSHCN HTW KHC
ATORVASTATIN 10 MG TABLET atorvastatin calcium	70377002711 BIOCON PHARMA I	Yes	No	Medicaid CHIP CSHCN HTW
ATORVASTATIN 10 MG TABLET atorvastatin calcium	60505257809 APOTEX CORP	Yes	No	Medicaid CHIP CSHCN HTW KHC
ATORVASTATIN 10 MG TABLET atorvastatin calcium	55111012190 DR.REDDY'S LAB	Yes	No	Medicaid CHIP CSHCN HTW KHC
ATORVASTATIN 10 MG TABLET atorvastatin calcium	42571017210 MICRO LABS USA,	Yes	No	Medicaid CHIP CSHCN
ATORVASTATIN 10 MG TABLET atorvastatin calcium	70377002713 BIOCON PHARMA I	Yes	No	Medicaid CHIP CSHCN HTW
ATORVASTATIN 10 MG TABLET atorvastatin calcium	42571017290 MICRO LABS USA,	Yes	No	Medicaid CHIP CSHCN