PERINDOPRIL

PERINDOPRIL (13494F)

perindopril arginine 2.5 mg tablet, 30
13494F
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $19.84 Max safety net: $21.38 General Patient Charge: $24.17
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 2.5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 2.5mg
*Additional charge for this brand is $18.68
 DPMQ: $38.52 Max safety net: $21.38 General Patient Charge: $42.85

PERINDOPRIL (13555K)

perindopril arginine 10 mg tablet, 30
13555K
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $22.84 Max safety net: $24.38 General Patient Charge: $25.00
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 10
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 10mg
*Additional charge for this brand is $18.78
 DPMQ: $41.62 Max safety net: $24.38 General Patient Charge: $43.78

PERINDOPRIL (13585B)

perindopril arginine 5 mg tablet, 30
13585B
Body System:
Manner of administration:Oral
General Schedule
Restricted Benefit

Restriction

Indication: The condition must be stable for the prescriber to consider the listed maximum quantity of this medicine suitable for this patient.
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 2 Max qty units: 60 # of repeats: 5 DPMQ: $21.16 Max safety net: $22.70 General Patient Charge: $25.00
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 5mg
*Additional charge for this brand is $18.12
 DPMQ: $39.28 Max safety net: $22.70 General Patient Charge: $43.12

PERINDOPRIL (9006B)

perindopril arginine 2.5 mg tablet, 30
9006B
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $17.10 Max safety net: $18.64 General Patient Charge: $21.43
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 2.5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 2.5mg
*Additional charge for this brand is $9.34
 DPMQ: $26.44 Max safety net: $18.64 General Patient Charge: $30.77

PERINDOPRIL (9007C)

perindopril arginine 5 mg tablet, 30
9007C
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $17.76 Max safety net: $19.30 General Patient Charge: $22.09
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 5
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 5mg
*Additional charge for this brand is $9.06
 DPMQ: $26.82 Max safety net: $19.30 General Patient Charge: $31.15

PERINDOPRIL (9008D)

perindopril arginine 10 mg tablet, 30
9008D
Body System:
Manner of administration:Oral
General Schedule
No restrictions
Quantities & Cost
Max qty packs Max qty units # of repeats DPMQ Max safety net General Patient Charge
Max qty packs: 1 Max qty units: 30 # of repeats: 5 DPMQ: $18.60 Max safety net: $20.14 General Patient Charge: $22.93
Available brands
APO-Perindopril Arginine
APX-Perindopril Arginine
PREXUM 10
Perindopril Arginine Sandoz
Perindopril Arginine-WGR
Coversyl 10mg
*Additional charge for this brand is $9.39
 DPMQ: $27.99 Max safety net: $20.14 General Patient Charge: $32.32