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
13622YMPNP	EZETIMIBE + ATORVASTATIN ezetimibe 10 mg + atorvastatin 20 mg tablet, 30 (PI, CMI)	2	60	5	$29.57	$31.02	$31.60
	Available brands
	Ezetasta
	Ezetimibe/Atorvastatin GH 10/20a
	Atozeta * Additional charge for this brand is $4.32B	2	60	5	$33.89	$31.02	$35.92