PERINDOPRIL

PERINDOPRIL (13494F)

perindopril arginine 2.5 mg tablet, 30
13494F
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: $19.22 Max safety net: $20.70 General Patient Charge: $23.49
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 2.5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 2.5mg
*Additional charge for this brand is $19.48
 DPMQ: $38.70 Max safety net: $20.70 General Patient Charge: $42.97

PERINDOPRIL (13555K)

perindopril arginine 10 mg tablet, 30
13555K
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: $22.40 Max safety net: $23.88 General Patient Charge: $25.00
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 10
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 10mg
*Additional charge for this brand is $19.50
 DPMQ: $41.90 Max safety net: $23.88 General Patient Charge: $44.50

PERINDOPRIL (13585B)

perindopril arginine 5 mg tablet, 30
13585B
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: $20.60 Max safety net: $22.08 General Patient Charge: $24.87
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 5mg
*Additional charge for this brand is $18.90
 DPMQ: $39.50 Max safety net: $22.08 General Patient Charge: $43.77

PERINDOPRIL (9006B)

perindopril arginine 2.5 mg tablet, 30
9006B
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: $16.50 Max safety net: $17.98 General Patient Charge: $20.77
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 2.5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 2.5mg
*Additional charge for this brand is $9.74
 DPMQ: $26.24 Max safety net: $17.98 General Patient Charge: $30.51

PERINDOPRIL (9007C)

perindopril arginine 5 mg tablet, 30
9007C
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: $17.19 Max safety net: $18.67 General Patient Charge: $21.46
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 5mg
*Additional charge for this brand is $9.45
 DPMQ: $26.64 Max safety net: $18.67 General Patient Charge: $30.91

PERINDOPRIL (9008D)

perindopril arginine 10 mg tablet, 30
9008D
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: $18.09 Max safety net: $19.57 General Patient Charge: $22.36
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 10
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 10mg
*Additional charge for this brand is $9.75
 DPMQ: $27.84 Max safety net: $19.57 General Patient Charge: $32.11