amlodipine besylate/benazepril HCl

10 mg-20 mg, 10 mg-40 mg, 2.5 mg-10 mg, 5 mg-10 mg, 5 mg-20 mg, 5 mg-40 mg — Capsule

Also known as: LOTREL AMLODIPINE BESYLATE-BENAZEPRIL

Informational only — Coverage rules change frequently; verify tier placement and restrictions with your plan or pharmacy before acting.

1 plan

Source: Excel (XLSX) · Formulary date: Jan 5, 2026 · Checked: 16 hours, 11 minutes ago

Plan	Tier	Prior Auth	Step Therapy	Quantity Limit	Restrictions
TRICARE Uniform Formulary 2026	Tier 1 - Basic Core Formulary	✓	—	—	PA