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
13512EMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	2	60	5	$34.25	$31.60	$31.60
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/5/25 tableta
	Olamlo HCT 40/5/25a
	Olmekar HCT 40/5/25a
	Sevikar HCT 40/5/25a * Additional charge for this brand is $5.34B	2	60	5	$39.59	$31.60	$36.94

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
2864RMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 25 mg tablet, 30 (PI, CMI)	1	30	5	$23.85	$25.30	$28.75
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/5/25 tableta
	Olamlo HCT 40/5/25a
	Olmekar HCT 40/5/25a
	Sevikar HCT 40/5/25a * Additional charge for this brand is $2.67B	1	30	5	$26.52	$25.30	$31.42