PERINDOPRIL + AMLODIPINE

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 (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