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: $23.10 Max safety net: $24.64 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 $21.96
 DPMQ: $45.06 Max safety net: $24.64 General Patient Charge: $46.96

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: $25.92 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 $22.98
 DPMQ: $48.90 Max safety net: $25.00 General Patient Charge: $47.98

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: $24.64 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 $22.32
 DPMQ: $46.96 Max safety net: $25.00 General Patient Charge: $47.32

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: $21.84 Max safety net: $23.38 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 $21.30
 DPMQ: $43.14 Max safety net: $23.38 General Patient Charge: $46.30

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: $18.10 Max safety net: $19.64 General Patient Charge: $22.43
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 $10.65
 DPMQ: $28.75 Max safety net: $19.64 General Patient Charge: $33.08

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: $18.73 Max safety net: $20.27 General Patient Charge: $23.06
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 $10.98
 DPMQ: $29.71 Max safety net: $20.27 General Patient Charge: $34.04

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: $19.50 Max safety net: $21.04 General Patient Charge: $23.83
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 $11.16
 DPMQ: $30.66 Max safety net: $21.04 General Patient Charge: $34.99

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: $20.14 Max safety net: $21.68 General Patient Charge: $24.47
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 $11.49
 DPMQ: $31.63 Max safety net: $21.68 General Patient Charge: $35.96