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

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
13440JMPNP	EZETIMIBE ezetimibe 10 mg tablet, 30 (PI, CMI)	2	60	5	$24.75	$26.20	$29.65
	Available brands
	APO-Ezetimibea
	BTC Ezetimibea
	EZEMICHOLa
	EZETIMIBE-WGRa
	Ezetimibe GHa
	Ezetimibe Sandoza
	Pharmacor Ezetimibe 10a
	Zient 10mga
	Ezetrola * Additional charge for this brand is $4.32B	2	60	5	$29.07	$26.20	$33.97

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

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
14668BMPNP	EZETIMIBE ezetimibe 10 mg tablet, 90 (PI, CMI)	0.67	60	5	$35.63	$31.60	$31.60
	Available brands
	Ezetimibe USP (Camber, USA)a

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

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
14682RMPNP	EZETIMIBE ezetimibe 10 mg tablet, 90 (PI, CMI)	0.33	30	5	$29.69	$31.14	$31.60
	Available brands
	Ezetimibe USP (Camber, USA)a

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

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
8757XMPNP	EZETIMIBE ezetimibe 10 mg tablet, 30 (PI, CMI)	1	30	5	$19.10	$20.55	$24.00
	Available brands
	APO-Ezetimibea
	BTC Ezetimibea
	EZEMICHOLa
	EZETIMIBE-WGRa
	Ezetimibe GHa
	Ezetimibe Sandoza
	Pharmacor Ezetimibe 10a
	Zient 10mga
	Ezetrola * Additional charge for this brand is $2.16B	1	30	5	$21.26	$20.55	$26.16