AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
Source | General Schedule |
Body System | CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS |
|
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 |
---|---|---|---|---|---|---|---|
13603YMPNP |
AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI) |
2 | 56 | 5 | $39.55 | $31.60 | $31.60 |
Available brands | |||||||
Amlodipine/Valsartan/HCT Novartis 5/160/25a | |||||||
Exforge HCT 5/160/25a * Additional charge for this brand is
$8.00B
|
2 | 56 | 5 | $47.55 | $31.60 | $39.60 |
AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE
Source | General Schedule |
Body System | CARDIOVASCULAR SYSTEM > AGENTS ACTING ON THE RENIN-ANGIOTENSIN SYSTEM > ANGIOTENSIN II RECEPTOR BLOCKERS (ARBs), COMBINATIONS |
|
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 |
---|---|---|---|---|---|---|---|
5286FMPNP | AMLODIPINE + VALSARTAN + HYDROCHLOROTHIAZIDE amlodipine 5 mg + valsartan 160 mg + hydrochlorothiazide 25 mg tablet, 28 (PI, CMI) |
1 | 28 | 5 | $26.50 | $27.95 | $31.40 |
Available brands | |||||||
Amlodipine/Valsartan/HCT Novartis 5/160/25a | |||||||
Exforge HCT 5/160/25a * Additional charge for this brand is
$4.00B
|
1 | 28 | 5 | $30.50 | $27.95 | $35.40 |
- Legend
- BBrand premium applies
- aBrand equivalent a
- MPMedical Practitioner
- NPNurse Practitioner
- 60D60-day prescriptions