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
13513FMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	2	60	5	$31.13	$31.60	$31.60
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/5/12.5 tableta
	Olamlo HCT 40/5/12.5a
	Olmekar HCT 40/5/12.5a
	Sevikar HCT 40/5/12.5a * Additional charge for this brand is $5.24B	2	60	5	$36.37	$31.60	$36.84

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
2880NMPNP	OLMESARTAN + AMLODIPINE + HYDROCHLOROTHIAZIDE olmesartan medoxomil 40 mg + amlodipine 5 mg + hydrochlorothiazide 12.5 mg tablet, 30 (PI, CMI)	1	30	5	$22.29	$23.74	$27.19
	Available brands
	APO-Olmesartan/Amlodipine/HCTZ 40/5/12.5 tableta
	Olamlo HCT 40/5/12.5a
	Olmekar HCT 40/5/12.5a
	Sevikar HCT 40/5/12.5a * Additional charge for this brand is $2.62B	1	30	5	$24.91	$23.74	$29.81