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

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
13384KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	2	60	5	$21.15	$22.60	$26.05
	Available brands
	Cadivast 10/20a
	Caduet 10/20a * Additional charge for this brand is $10.00B	2	60	5	$31.15	$22.60	$36.05

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

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
13415CMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$21.59	$23.04	$26.49
	Available brands
	Cadivast 5/40a
	Caduet 5/40a * Additional charge for this brand is $10.00B	2	60	5	$31.59	$23.04	$36.49

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

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
13479KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	2	60	5	$20.75	$22.20	$25.65
	Available brands
	Cadivast 10/10a
	Caduet 10/10a * Additional charge for this brand is $10.00B	2	60	5	$30.75	$22.20	$35.65

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

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
13536KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	2	60	5	$22.97	$24.42	$27.87
	Available brands
	Cadivast 10/40a
	Caduet 10/40a * Additional charge for this brand is $10.00B	2	60	5	$32.97	$24.42	$37.87

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

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
13567CMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	2	60	5	$20.85	$22.30	$25.75
	Available brands
	Cadivast 5/20

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

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
13596NMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	2	60	5	$19.39	$20.84	$24.29
	Available brands
	Cadivast 5/10

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

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
13597PMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	2	60	5	$24.33	$25.78	$29.23
	Available brands
	Cadivast 5/80a
	Caduet 5/80a * Additional charge for this brand is $10.00B	2	60	5	$34.33	$25.78	$39.23

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

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
13963XMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	2	60	5	$25.71	$27.16	$30.61
	Available brands
	Cadivast 10/80a
	Caduet 10/80a * Additional charge for this brand is $10.00B	2	60	5	$35.71	$27.16	$40.61

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

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
9049GMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	1	30	5	$16.42	$17.87	$21.32
	Available brands
	Cadivast 5/10

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

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
9050HMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	1	30	5	$17.15	$18.60	$22.05
	Available brands
	Cadivast 5/20

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

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
9051JMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	1	30	5	$17.52	$18.97	$22.42
	Available brands
	Cadivast 5/40a
	Caduet 5/40a * Additional charge for this brand is $5.00B	1	30	5	$22.52	$18.97	$27.42

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

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
9052KMPNP	AMLODIPINE + ATORVASTATIN amlodipine 5 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	1	30	5	$18.89	$20.34	$23.79
	Available brands
	Cadivast 5/80a
	Caduet 5/80a * Additional charge for this brand is $5.00B	1	30	5	$23.89	$20.34	$28.79

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

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
9053LMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 10 mg tablet, 30 (PI, CMI)	1	30	5	$17.10	$18.55	$22.00
	Available brands
	Cadivast 10/10a
	Caduet 10/10a * Additional charge for this brand is $5.00B	1	30	5	$22.10	$18.55	$27.00

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

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
9054MMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	1	30	5	$17.30	$18.75	$22.20
	Available brands
	Cadivast 10/20a
	Caduet 10/20a * Additional charge for this brand is $5.00B	1	30	5	$22.30	$18.75	$27.20

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

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
9055NMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 40 mg tablet, 30 (PI, CMI)	1	30	5	$18.21	$19.66	$23.11
	Available brands
	Cadivast 10/40a
	Caduet 10/40a * Additional charge for this brand is $5.00B	1	30	5	$23.21	$19.66	$28.11

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

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
9056PMPNP	AMLODIPINE + ATORVASTATIN amlodipine 10 mg + atorvastatin 80 mg tablet, 30 (PI, CMI)	1	30	5	$19.58	$21.03	$24.48
	Available brands
	Cadivast 10/80a
	Caduet 10/80a * Additional charge for this brand is $5.00B	1	30	5	$24.58	$21.03	$29.48