PERINDOPRIL + INDAPAMIDE

PERINDOPRIL + INDAPAMIDE (13506W)

perindopril arginine 5 mg + indapamide hemihydrate 1.25 mg tablet, 30
13506W
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: $21.32 Max safety net: $22.80 General Patient Charge: $25.00
Available brands
Prexum Combi 5/1.25
Coversyl Plus 5mg/1.25mg
*Additional charge for this brand is $14.28
 DPMQ: $35.60 Max safety net: $22.80 General Patient Charge: $39.28

PERINDOPRIL + INDAPAMIDE (2845R)

perindopril arginine 5 mg + indapamide hemihydrate 1.25 mg tablet, 30
2845R
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: $17.55 Max safety net: $19.03 General Patient Charge: $21.82
Available brands
Prexum Combi 5/1.25
Coversyl Plus 5mg/1.25mg
*Additional charge for this brand is $7.14
 DPMQ: $24.69 Max safety net: $19.03 General Patient Charge: $28.96