AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE

Source General Schedule
Body System CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
13390RMPNP
AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)
2 56 5 $40.61 $31.60 $31.60
Available brands
Amlodipine/Valsartan/HCT Novartis 10/160/25a
Exforge HCT 10/160/25a
* Additional charge for this brand is $20.00B
2 56 5 $60.61 $31.60 $51.60
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AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE

Source General Schedule
Body System CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
5288HMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)
1 28 5 $27.03 $28.48 $31.60
Available brands
Amlodipine/Valsartan/HCT Novartis 10/160/25a
Exforge HCT 10/160/25a
* Additional charge for this brand is $10.00B
1 28 5 $37.03 $28.48 $41.60
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner
  • 60D60-day prescriptions