Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10201XMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 20 mg tablet [30], 60 (PI, CMI)	1	1	5	$21.93	$23.38	$26.83
	Available brands
	Ezalo Composite Pack 10mg+20mga
	Pharmacor Ezetimibe Rosuvastatin Composite Packa
	Rosuzet Composite Packa * Additional charge for this brand is $2.98B	1	1	5	$24.91	$23.38	$29.81

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10204CMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 5 mg tablet [30], 60 (PI, CMI)	1	1	5	$20.72	$22.17	$25.62
	Available brands
	Ezalo Composite Pack 10mg+5mga
	Rosuzet Composite Packa * Additional charge for this brand is $2.87B	1	1	5	$23.59	$22.17	$28.49

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10207FMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60 (PI, CMI)	1	1	5	$23.07	$24.52	$27.97
	Available brands
	Ezalo Composite Pack 10mg+40mga
	Pharmacor Ezetimibe Rosuvastatin Composite Packa
	Rosuzet Composite Packa * Additional charge for this brand is $3.09B	1	1	5	$26.16	$24.52	$31.06

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
10208GMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 10 mg tablet [30], 60 (PI, CMI)	1	1	5	$22.10	$23.55	$27.00
	Available brands
	Ezalo Composite Pack 10mg+10mga
	Pharmacor Ezetimibe Rosuvastatin Composite Packa
	Rosuzet Composite Packa * Additional charge for this brand is $2.97B	1	1	5	$25.07	$23.55	$29.97

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13480LMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 20 mg tablet [30], 60 (PI, CMI)	2	2	5	$30.41	$31.60	$31.60
	Available brands
	Ezalo Composite Pack 10mg+20mga
	Pharmacor Ezetimibe Rosuvastatin Composite Packa
	Rosuzet Composite Packa * Additional charge for this brand is $5.96B	2	2	5	$36.37	$31.60	$37.56

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13537LMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 40 mg tablet [30], 60 (PI, CMI)	2	2	5	$32.69	$31.60	$31.60
	Available brands
	Ezalo Composite Pack 10mg+40mga
	Pharmacor Ezetimibe Rosuvastatin Composite Packa
	Rosuzet Composite Packa * Additional charge for this brand is $6.18B	2	2	5	$38.87	$31.60	$37.78

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13569EMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 10 mg tablet [30], 60 (PI, CMI)	2	2	5	$30.75	$31.60	$31.60
	Available brands
	Ezalo Composite Pack 10mg+10mga
	Pharmacor Ezetimibe Rosuvastatin Composite Packa
	Rosuzet Composite Packa * Additional charge for this brand is $5.94B	2	2	5	$36.69	$31.60	$37.54

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > LIPID MODIFYING AGENTS > LIPID MODIFYING AGENTS, COMBINATIONS

Note

Restricted Benefit

Code & Prescriber	Medicinal Product Pack (Name, form & strength and pack size)	Max qty packs	Max qty units	No. of repeats	DPMQ	Max Safety Net	General Patient Charge
13629HMPNP	EZETIMIBE (&) ROSUVASTATIN ezetimibe 10 mg tablet [30] (&) rosuvastatin 5 mg tablet [30], 60 (PI, CMI)	2	2	5	$27.99	$29.44	$31.60
	Available brands
	Ezalo Composite Pack 10mg+5mga
	Rosuzet Composite Packa * Additional charge for this brand is $5.74B	2	2	5	$33.73	$29.44	$37.34