AMLODIPINE

AMLODIPINE (13532F)

amlodipine 5 mg tablet, 30
13532F
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $19.84 Max safety net: $21.38 General Patient Charge: $24.17
Available brands
AMLODIPINE-WGR
APO-Amlodipine
APX-AMLODIPINE
Amlo 5
Amlodipine GH
Amlodipine Sandoz
Blooms Amlodipine
Nordip
Pharmacor Amlodipine
Norvasc
*Additional charge for this brand is $21.46
 DPMQ: $41.30 Max safety net: $21.38 General Patient Charge: $45.63

AMLODIPINE (13562T)

amlodipine 10 mg tablet, 30
13562T
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $19.84 Max safety net: $21.38 General Patient Charge: $24.17
Available brands
AMLODIPINE-WGR
APO-Amlodipine
APX-AMLODIPINE
Amlo 10
Amlodipine GH
Amlodipine Sandoz
Blooms Amlodipine
Nordip
Pharmacor Amlodipine
Norvasc
*Additional charge for this brand is $21.48
 DPMQ: $41.32 Max safety net: $21.38 General Patient Charge: $45.65

AMLODIPINE (2751T)

amlodipine 5 mg tablet, 30
2751T
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
AMLODIPINE-WGR
APO-Amlodipine
APX-AMLODIPINE
Amlo 5
Amlodipine GH
Amlodipine Sandoz
Blooms Amlodipine
Nordip
Pharmacor Amlodipine
Norvasc
*Additional charge for this brand is $10.73
 DPMQ: $27.83 Max safety net: $18.64 General Patient Charge: $32.16

AMLODIPINE (2752W)

amlodipine 10 mg tablet, 30
2752W
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
AMLODIPINE-WGR
APO-Amlodipine
APX-AMLODIPINE
Amlo 10
Amlodipine GH
Amlodipine Sandoz
Blooms Amlodipine
Nordip
Pharmacor Amlodipine
Norvasc
*Additional charge for this brand is $10.74
 DPMQ: $27.84 Max safety net: $18.64 General Patient Charge: $32.17