Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13393XMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 80 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	2	56	5	$26.33	$27.73	$31.18
	Available brands
	Co-Diovan 80/12.5a
	Dilart HCT 80/12.5a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13453CMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	2	56	5	$31.69	$31.60	$31.60
	Available brands
	Co-Diovan 160/25a
	Dilart HCT 160/25a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13455EMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 320 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	2	56	5	$35.71	$31.60	$31.60
	Available brands
	Co-Diovan 320/25a
	Dilart HCT 320/25a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13517KMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 320 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	2	56	5	$33.53	$31.60	$31.60
	Available brands
	Co-Diovan 320/12.5a
	Dilart HCT 320/12.5a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13606DMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	2	56	5	$29.49	$30.89	$31.60
	Available brands
	Co-Diovan 160/12.5a
	Dilart HCT 160/12.5a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9372GMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 80 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	1	28	5	$19.66	$21.06	$24.51
	Available brands
	Co-Diovan 80/12.5a
	Dilart HCT 80/12.5a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9373HMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	1	28	5	$21.24	$22.64	$26.09
	Available brands
	Co-Diovan 160/12.5a
	Dilart HCT 160/12.5a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9374JMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	1	28	5	$22.34	$23.74	$27.19
	Available brands
	Co-Diovan 160/25a
	Dilart HCT 160/25a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9481BMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 320 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	1	28	5	$23.26	$24.66	$28.11
	Available brands
	Co-Diovan 320/12.5a
	Dilart HCT 320/12.5a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
9482CMPNP	VALSARTAN + HYDROCHLOROTHIAZIDE valsartan 320 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	1	28	5	$24.35	$25.75	$29.20
	Available brands
	Co-Diovan 320/25a
	Dilart HCT 320/25a