Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
13447RMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 20 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	2	60	5	$22.07	$23.52	$26.97
	Available brands
	APO-Olmesartan/HCTZ 20/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 20/12.5a
	OLMESARTAN HCTZ-WGR 20/12.5a
	Olmesartan HCT - MYL 20/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 20/12.5a
	Olmetec Plusa * Additional charge for this brand is $6.00B	2	60	5	$28.07	$23.52	$32.97

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
13601WMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	2	60	5	$25.27	$26.72	$30.17
	Available brands
	APO-Olmesartan/HCTZ 40/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/12.5a
	OLMESARTAN HCTZ-WGR 40/12.5a
	Olmesartan HCT - MYL 40/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/12.5a
	Olmetec Plusa * Additional charge for this brand is $8.00B	2	60	5	$33.27	$26.72	$38.17

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
13602XMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	2	60	5	$26.81	$28.26	$31.60
	Available brands
	APO-Olmesartan/HCTZ 40/25a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/25a
	OLMESARTAN HCTZ-WGR 40/25a
	Olmesartan HCT - MYL 40/25a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/25a
	Olmetec Plusa * Additional charge for this brand is $8.00B	2	60	5	$34.81	$28.26	$39.60

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
2161RMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 20 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	1	30	5	$17.76	$19.21	$22.66
	Available brands
	APO-Olmesartan/HCTZ 20/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 20/12.5a
	OLMESARTAN HCTZ-WGR 20/12.5a
	Olmesartan HCT - MYL 20/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 20/12.5a
	Olmetec Plusa * Additional charge for this brand is $3.00B	1	30	5	$20.76	$19.21	$25.66

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
2166BMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	1	30	5	$19.36	$20.81	$24.26
	Available brands
	APO-Olmesartan/HCTZ 40/12.5a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/12.5a
	OLMESARTAN HCTZ-WGR 40/12.5a
	Olmesartan HCT - MYL 40/12.5a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/12.5a
	Olmetec Plusa * Additional charge for this brand is $4.00B	1	30	5	$23.36	$20.81	$28.26

Source	General Schedule
Body System	CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), 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
2170FMPNP	OLMESARTAN + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	1	30	5	$20.13	$21.58	$25.03
	Available brands
	APO-Olmesartan/HCTZ 40/25a
	APX-Olmesartan/HCTZa
	OLMERTAN COMBI 40/25a
	OLMESARTAN HCTZ-WGR 40/25a
	Olmesartan HCT - MYL 40/25a
	Olmesartan/HCT Sandoza
	Pharmacor Olmesartan HCTZ 40/25a
	Olmetec Plusa * Additional charge for this brand is $4.00B	1	30	5	$24.13	$21.58	$29.03