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
10376DMPNP	EZETIMIBE + ATORVASTATIN ezetimibe 10 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	1	30	5	$23.41	$24.86	$28.31
	Available brands
	Ezetasta
	Ezetimibe/Atorvastatin GH 10/80a
	Atozeta * Additional charge for this brand is $2.21B	1	30	5	$25.62	$24.86	$30.52

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
13538MMPNP	EZETIMIBE + ATORVASTATIN ezetimibe 10 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	2	60	5	$33.37	$31.60	$31.60
	Available brands
	Ezetasta
	Ezetimibe/Atorvastatin GH 10/80a
	Atozeta * Additional charge for this brand is $4.42B	2	60	5	$37.79	$31.60	$36.02