PERINDOPRIL + AMLODIPINE

PERINDOPRIL + AMLODIPINE (13508Y)

perindopril arginine 5 mg + amlodipine 5 mg tablet, 30
13508Y
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
APO-Perindopril Arginine/Amlodipine 5/5
APX-Perindopril Arginine/Amlodipine 5/5
Perindopril Arginine/Amlodipine-WGR 5/5
Reaptan 5/5
Coveram 5/5
*Additional charge for this brand is $22.16
 DPMQ: $43.48 Max safety net: $22.80 General Patient Charge: $47.16

PERINDOPRIL + AMLODIPINE (9346X)

perindopril arginine 5 mg + amlodipine 5 mg tablet, 30
9346X
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
APO-Perindopril Arginine/Amlodipine 5/5
APX-Perindopril Arginine/Amlodipine 5/5
Perindopril Arginine/Amlodipine-WGR 5/5
Reaptan 5/5
Coveram 5/5
*Additional charge for this brand is $11.08
 DPMQ: $28.63 Max safety net: $19.03 General Patient Charge: $32.90