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
13447RMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 20 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	2	60	5	$21.59	$22.99	$26.44
	Available brands
	APO-Olmesartan/HCTZ 20/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 20/12.5a
	Olmesartan HCT - MYL 20/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 20/12.5a
	Olmetec Plusa * Additional charge for this brand is $6.00B	2	60	5	$27.59	$22.99	$32.44

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
13601WMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	2	60	5	$24.79	$26.19	$29.64
	Available brands
	APO-Olmesartan/HCTZ 40/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/12.5a
	Olmesartan HCT - MYL 40/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/12.5a
	Olmetec Plusa * Additional charge for this brand is $6.50B	2	60	5	$31.29	$26.19	$36.14

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
13602XMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	2	60	5	$26.33	$27.73	$31.18
	Available brands
	APO-Olmesartan/HCTZ 40/25a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/25a
	Olmesartan HCT - MYL 40/25a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/25a
	Olmetec Plusa * Additional charge for this brand is $4.52B	2	60	5	$30.85	$27.73	$35.70

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
2161RMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 20 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	1	30	5	$17.29	$18.69	$22.14
	Available brands
	APO-Olmesartan/HCTZ 20/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 20/12.5a
	Olmesartan HCT - MYL 20/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 20/12.5a
	Olmetec Plusa * Additional charge for this brand is $3.00B	1	30	5	$20.29	$18.69	$25.14

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
2166BMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	1	30	5	$18.89	$20.29	$23.74
	Available brands
	APO-Olmesartan/HCTZ 40/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/12.5a
	Olmesartan HCT - MYL 40/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/12.5a
	Olmetec Plusa * Additional charge for this brand is $3.25B	1	30	5	$22.14	$20.29	$26.99

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
2170FMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	1	30	5	$19.66	$21.06	$24.51
	Available brands
	APO-Olmesartan/HCTZ 40/25a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/25a
	Olmesartan HCT - MYL 40/25a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/25a
	Olmetec Plusa * Additional charge for this brand is $2.26B	1	30	5	$21.92	$21.06	$26.77