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
13607EMPNP	TELMISARTAN + HYDROCHLOROTHIAZIDE telmisartan 80 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI)	2	56	5	$22.73	$24.18	$27.63
	Available brands
	APO-Telmisartan HCTZ 80/25a
	Mizart HCT 80/25 mga
	TELMISARTAN HCTZ-WGR 80/25a
	Telmisartan/HCT Sandoza
	Teltartan HCT 80/25a
	Micardis Plus 80/25 mga * Additional charge for this brand is $20.00B	2	56	5	$42.73	$24.18	$47.63