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 $23.67 $24.98 $28.27
Available brands
Valsartan/Amlodipine/HCT Novartis 160/5/12.5a
Exforge HCT 5/160/12.5a
* Additional charge for this brand is $10.00B
1 28 5 $33.67 $24.98 $38.27
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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
5286FMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)
1 28 5 $25.18 $26.49 $29.78
Available brands
Valsartan/Amlodipine/HCT Novartis 160/5/25a
Exforge HCT 5/160/25a
* Additional charge for this brand is $4.00B
1 28 5 $29.18 $26.49 $33.78
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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
5287GMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)
1 28 5 $24.19 $25.50 $28.79
Available brands
Valsartan/Amlodipine/HCT Novartis 160/10/12.5a
Exforge HCT 10/160/12.5a
* Additional charge for this brand is $4.00B
1 28 5 $28.19 $25.50 $32.79
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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
5288HMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 10 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)
1 28 5 $25.71 $27.02 $30.00
Available brands
Valsartan/Amlodipine/HCT Novartis 160/10/25a
Exforge HCT 10/160/25a
* Additional charge for this brand is $10.00B
1 28 5 $35.71 $27.02 $40.00
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner