Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

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
10377EMPNP	EZETIMIBE + ATORVASTATIN ezetimibe 10 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	1	30	5	$22.42	$23.87	$27.32
	Available brands
	Ezetasta
	Ezetimibe/Atorvastatin GH 10/40a
	Atozeta * Additional charge for this brand is $2.22B	1	30	5	$24.64	$23.87	$29.54

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13416DMPNP	EZETIMIBE + ATORVASTATIN ezetimibe 10 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$31.39	$31.60	$31.60
	Available brands
	Ezetasta
	Ezetimibe/Atorvastatin GH 10/40a
	Atozeta * Additional charge for this brand is $4.44B	2	60	5	$35.83	$31.60	$36.04