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
13448TMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)
2 56 5 $36.53 $31.60 $31.60
Available brands
Amlodipine/Valsartan/HCT Novartis 5/160/12.5a
Exforge HCT 5/160/12.5a
* Additional charge for this brand is $20.00B
2 56 5 $56.53 $31.60 $51.60
space

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
5285EMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)
1 28 5 $24.99 $26.44 $29.89
Available brands
Amlodipine/Valsartan/HCT Novartis 5/160/12.5a
Exforge HCT 5/160/12.5a
* Additional charge for this brand is $10.00B
1 28 5 $34.99 $26.44 $39.89
space


  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner