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
5285EMPNP	AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	1	28	5	$24.52	$25.92	$29.37
	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	$34.52	$25.92	$39.37

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
5286FMPNP	AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	1	28	5	$26.03	$27.43	$30.88
	Available brands
	Amlodipine/Valsartan/HCT Novartis 5/160/25a
	Exforge HCT 5/160/25a * Additional charge for this brand is $4.00B	1	28	5	$30.03	$27.43	$34.88

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
5287GMPNP	AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE amlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	1	28	5	$25.04	$26.44	$29.89
	Available brands
	Amlodipine/Valsartan/HCT Novartis 10/160/12.5a
	Exforge HCT 10/160/12.5a * Additional charge for this brand is $4.00B	1	28	5	$29.04	$26.44	$33.89

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
5288HMPNP	AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE amlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	1	28	5	$26.56	$27.96	$31.41
	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	$36.56	$27.96	$41.41