Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13384KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	2	60	5	$21.48	$22.96	$25.00
	Available brands
	Cadivast 10/20a
	Caduet 10/20a * Additional charge for this brand is $10.00B	2	60	5	$31.48	$22.96	$35.00

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13415CMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$21.92	$23.40	$25.00
	Available brands
	Cadivast 5/40a
	Caduet 5/40a

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13479KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	2	60	5	$21.08	$22.56	$25.00
	Available brands
	Cadivast 10/10a
	Caduet 10/10a * Additional charge for this brand is $10.00B	2	60	5	$31.08	$22.56	$35.00

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13536KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$23.30	$24.78	$25.00
	Available brands
	Cadivast 10/40a
	Caduet 10/40a * Additional charge for this brand is $10.00B	2	60	5	$33.30	$24.78	$35.00

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13567CMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	2	60	5	$21.18	$22.66	$25.00
	Available brands
	Cadivast 5/20

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13596NMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	2	60	5	$19.72	$21.20	$23.99
	Available brands
	Cadivast 5/10

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13597PMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	2	60	5	$24.66	$25.00	$25.00
	Available brands
	Cadivast 5/80a
	Caduet 5/80a * Additional charge for this brand is $10.00B	2	60	5	$34.66	$25.00	$35.00

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, 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
13963XMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	2	60	5	$26.04	$25.00	$25.00
	Available brands
	Cadivast 10/80a
	Caduet 10/80a * Additional charge for this brand is $10.00B	2	60	5	$36.04	$25.00	$35.00

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

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
9049GMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	1	30	5	$16.75	$18.23	$21.02
	Available brands
	Cadivast 5/10

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

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
9050HMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	1	30	5	$17.48	$18.96	$21.75
	Available brands
	Cadivast 5/20

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

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
9051JMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	1	30	5	$17.85	$19.33	$22.12
	Available brands
	Cadivast 5/40a
	Caduet 5/40a

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

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
9052KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	1	30	5	$19.22	$20.70	$23.49
	Available brands
	Cadivast 5/80a
	Caduet 5/80a * Additional charge for this brand is $5.00B	1	30	5	$24.22	$20.70	$28.49

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

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
9053LMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	1	30	5	$17.43	$18.91	$21.70
	Available brands
	Cadivast 10/10a
	Caduet 10/10a * Additional charge for this brand is $5.00B	1	30	5	$22.43	$18.91	$26.70

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

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
9054MMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	1	30	5	$17.63	$19.11	$21.90
	Available brands
	Cadivast 10/20a
	Caduet 10/20a * Additional charge for this brand is $5.00B	1	30	5	$22.63	$19.11	$26.90

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

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
9055NMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	1	30	5	$18.54	$20.02	$22.81
	Available brands
	Cadivast 10/40a
	Caduet 10/40a * Additional charge for this brand is $5.00B	1	30	5	$23.54	$20.02	$27.81

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

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
9056PMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	1	30	5	$19.91	$21.39	$24.18
	Available brands
	Cadivast 10/80a
	Caduet 10/80a * Additional charge for this brand is $5.00B	1	30	5	$24.91	$21.39	$29.18