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 $29.52
Available brands
Valsartan/Amlodipine/HCT Novartis 160/5/12.5a
Exforge HCT 5/160/12.5a
* Additional charge for this brand is $3.00B
1 28 5 $26.67 $24.98 $32.52
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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 $31.03
Available brands
Valsartan/Amlodipine/HCT Novartis 160/5/25a
Exforge HCT 5/160/25a
* Additional charge for this brand is $3.00B
1 28 5 $28.18 $26.49 $34.03
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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 $24.31 $25.62 $30.16
Available brands
Valsartan/Amlodipine/HCT Novartis 160/10/12.5a
Exforge HCT 10/160/12.5a
* Additional charge for this brand is $3.00B
1 28 5 $27.31 $25.62 $33.16
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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 $25.83 $27.14 $31.68
Available brands
Valsartan/Amlodipine/HCT Novartis 160/10/25a
Exforge HCT 10/160/25a
* Additional charge for this brand is $3.00B
1 28 5 $28.83 $27.14 $34.68
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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
5289JMPNP AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
amlodipine 10 mg + valsartan 320 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)
1 28 5 $28.42 $29.73 $34.27
Available brands
Valsartan/Amlodipine/HCT Novartis 320/10/25a
Exforge HCT 10/320/25a
* Additional charge for this brand is $3.00B
1 28 5 $31.42 $29.73 $37.27
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  • Legend
  • BBrand premium applies
  • aBrand equivalent a
  • MPMedical Practitioner
  • NPNurse Practitioner