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	$22.40	$23.88	$27.33
	Available brands
	APO-Olmesartan/HCTZ 20/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 20/12.5a
	OLMESARTAN HCTZ-WGR 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	$28.40	$23.88	$33.33

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	$25.60	$27.08	$30.53
	Available brands
	APO-Olmesartan/HCTZ 40/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/12.5a
	OLMESARTAN HCTZ-WGR 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 $9.00B	2	60	5	$34.60	$27.08	$39.53

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	$27.14	$28.62	$31.60
	Available brands
	APO-Olmesartan/HCTZ 40/25a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/25a
	OLMESARTAN HCTZ-WGR 40/25a
	Olmesartan HCT - MYL 40/25a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/25a
	Olmetec Plusa * Additional charge for this brand is $9.00B	2	60	5	$36.14	$28.62	$40.60

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	$18.09	$19.57	$23.02
	Available brands
	APO-Olmesartan/HCTZ 20/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 20/12.5a
	OLMESARTAN HCTZ-WGR 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	$21.09	$19.57	$26.02

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	$19.69	$21.17	$24.62
	Available brands
	APO-Olmesartan/HCTZ 40/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/12.5a
	OLMESARTAN HCTZ-WGR 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 $4.50B	1	30	5	$24.19	$21.17	$29.12

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	$20.46	$21.94	$25.39
	Available brands
	APO-Olmesartan/HCTZ 40/25a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/25a
	OLMESARTAN HCTZ-WGR 40/25a
	Olmesartan HCT - MYL 40/25a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/25a
	Olmetec Plusa * Additional charge for this brand is $4.50B	1	30	5	$24.96	$21.94	$29.89