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
13535JMPNP	EZETIMIBE + SIMVASTATIN ezetimibe 10 mg + simvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$32.50	$31.60	$31.60
	Available brands
	APO-Ezetimibe/Simvastatin 10/40a
	EZETIMIBE/SIMVASTATIN SANDOZa
	EZETIMIBE/SIMVASTATIN-WGR 10/40a
	EZETORINa
	EzSimva GH 10/40a
	Pharmacor Ezetimibe Simvastatin 10/40a
	Zimybe 10/40a
	Vytorina * Additional charge for this brand is $4.00B	2	60	5	$36.50	$31.60	$35.60

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
8881KMPNP	EZETIMIBE + SIMVASTATIN ezetimibe 10 mg + simvastatin 40 mg tablet, 30 (PI, CMI)	1	30	5	$23.14	$24.62	$28.07
	Available brands
	APO-Ezetimibe/Simvastatin 10/40a
	EZETIMIBE/SIMVASTATIN SANDOZa
	EZETIMIBE/SIMVASTATIN-WGR 10/40a
	EZETORINa
	EzSimva GH 10/40a
	Pharmacor Ezetimibe Simvastatin 10/40a
	Zimybe 10/40a
	Vytorina * Additional charge for this brand is $2.00B	1	30	5	$25.14	$24.62	$30.07