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
14002YMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	2	60	5	$35.34	$31.60	$31.60
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/10/25a
	Olamlo HCT 40/10/25a
	Sevikar HCT 40/10/25a * Additional charge for this brand is $8.00B	2	60	5	$43.34	$31.60	$39.60