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
13482NMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	2	60	5	$31.95	$31.60	$31.60
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/10/12.5a
	Olamlo HCT 40/10/12.5a
	Olmekar HCT 40/10/12.5a
	Sevikar HCT 40/10/12.5a * Additional charge for this brand is $8.52B	2	60	5	$40.47	$31.60	$40.12

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
2836GMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 10 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	1	30	5	$22.70	$24.15	$27.60
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/10/12.5a
	Olamlo HCT 40/10/12.5a
	Olmekar HCT 40/10/12.5a
	Sevikar HCT 40/10/12.5a * Additional charge for this brand is $4.26B	1	30	5	$26.96	$24.15	$31.86