COMBIPATCH 0.05-0.14 MG PTCH

Drug Details

General

Brand Name: COMBIPATCH 0.05-0.14 MG PTCH
Generic Name: estradiol/norethindrone acet
Manufacturer: NOVEN THERAPEUT
NDC: 68968051408
Package size: 8EA

Drug Information

Family Planning drug: No
Diabetic Supply Drug: No
HTW drug: No
HTWPlus drug: No
Long-acting reversible contraception product: No
Refill-to-soon Utilization*: 75%
Specialty Drug†: No

Drug Pricing

Retail Pharmacy Cost: 29.72218
Retail Pharmacy Eff Date: 01/03/2024
Specialty Pharmacy Cost: 29.20204
Specialty Pharmacy Eff Date: 01/03/2024
Long-term Care Pharmacy Cost: 29.00884
Long-term Care Pharmacy Eff Date: 01/03/2024
340B Rate: 13.32785
Premium Preferred Generic Incentive‡: No

* Impacts only claims paid by HHSC: traditional Medicaid, CSHCN, HTW, and KHC Programs.

† Refer to the Specialty Drug Handbook for more information..

‡ Refer to the Premium Preferred Generic Drugs section for information about traditional Medicaid claim pricing and PPG pricing incentives.