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
13546YMPNP	TELMISARTAN + HYDROCHLOROTHIAZIDE telmisartan 40 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	2	56	5	$19.13	$20.58	$24.03
	Available brands
	APO-Telmisartan HCTZ 40/12.5a
	Mizart HCT 40/12.5 mga
	TELMISARTAN HCTZ-WGR 40/12.5a
	Telmisartan/HCT Sandoza
	Teltartan HCT 40/12.5a
	Micardis Plus 40/12.5 mga * Additional charge for this brand is $11.08B	2	56	5	$30.21	$20.58	$35.11

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
8622TMPNP	TELMISARTAN + HYDROCHLOROTHIAZIDE telmisartan 40 mg + hydrochlorothiazide 12.5 mg tablet, 28 (PI, CMI)	1	28	5	$16.29	$17.74	$21.19
	Available brands
	APO-Telmisartan HCTZ 40/12.5a
	Mizart HCT 40/12.5 mga
	TELMISARTAN HCTZ-WGR 40/12.5a
	Telmisartan/HCT Sandoza
	Teltartan HCT 40/12.5a
	Micardis Plus 40/12.5 mga * Additional charge for this brand is $5.54B	1	28	5	$21.83	$17.74	$26.73