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 (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