PERINDOPRIL + AMLODIPINE

PERINDOPRIL + AMLODIPINE (13381G)

perindopril arginine 5 mg + amlodipine 10 mg tablet, 30
13381G
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: $22.68 Max safety net: $24.16 General Patient Charge: $25.00
Available brands
APO-Perindopril Arginine/Amlodipine 5/10
APX-Perindopril Arginine/Amlodipine 5/10
Perindopril Arginine/Amlodipine-WGR 5/10
Reaptan 5/10
Coveram 5/10
*Additional charge for this brand is $22.78
 DPMQ: $45.46 Max safety net: $24.16 General Patient Charge: $47.78

PERINDOPRIL + AMLODIPINE (13382H)

perindopril arginine 10 mg + amlodipine 10 mg tablet, 30
13382H
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: $25.72 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Perindopril Arginine/Amlodipine 10/10
APX-Perindopril Arginine/Amlodipine 10/10
Perindopril Arginine/Amlodipine-WGR 10/10
Reaptan 10/10
Coveram 10/10
*Additional charge for this brand is $23.70
 DPMQ: $49.42 Max safety net: $25.00 General Patient Charge: $48.70

PERINDOPRIL + AMLODIPINE (13478J)

perindopril arginine 10 mg + amlodipine 5 mg tablet, 30
13478J
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: $24.34 Max safety net: $25.00 General Patient Charge: $25.00
Available brands
APO-Perindopril Arginine/Amlodipine 10/5
APX-Perindopril Arginine/Amlodipine 10/5
Perindopril Arginine/Amlodipine-WGR 10/5
Reaptan 10/5
Coveram 10/5
*Additional charge for this brand is $23.08
 DPMQ: $47.42 Max safety net: $25.00 General Patient Charge: $48.08

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

PERINDOPRIL + AMLODIPINE (9347Y)

perindopril arginine 5 mg + amlodipine 10 mg tablet, 30
9347Y
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: $18.23 Max safety net: $19.71 General Patient Charge: $22.50
Available brands
APO-Perindopril Arginine/Amlodipine 5/10
APX-Perindopril Arginine/Amlodipine 5/10
Perindopril Arginine/Amlodipine-WGR 5/10
Reaptan 5/10
Coveram 5/10
*Additional charge for this brand is $11.39
 DPMQ: $29.62 Max safety net: $19.71 General Patient Charge: $33.89

PERINDOPRIL + AMLODIPINE (9348B)

perindopril arginine 10 mg + amlodipine 5 mg tablet, 30
9348B
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: $19.06 Max safety net: $20.54 General Patient Charge: $23.33
Available brands
APO-Perindopril Arginine/Amlodipine 10/5
APX-Perindopril Arginine/Amlodipine 10/5
Perindopril Arginine/Amlodipine-WGR 10/5
Reaptan 10/5
Coveram 10/5
*Additional charge for this brand is $11.54
 DPMQ: $30.60 Max safety net: $20.54 General Patient Charge: $34.87

PERINDOPRIL + AMLODIPINE (9349C)

perindopril arginine 10 mg + amlodipine 10 mg tablet, 30
9349C
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: $19.75 Max safety net: $21.23 General Patient Charge: $24.02
Available brands
APO-Perindopril Arginine/Amlodipine 10/10
APX-Perindopril Arginine/Amlodipine 10/10
Perindopril Arginine/Amlodipine-WGR 10/10
Reaptan 10/10
Coveram 10/10
*Additional charge for this brand is $11.85
 DPMQ: $31.60 Max safety net: $21.23 General Patient Charge: $35.87