1 Drug
Try a full estimate — pick a drug
Allowed / Unit
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CMS ASP+6% payment limit
Billing Units
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Drug Cost
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CMS payment limit (ASP+6%)
NOC codes require a manufacturer NDC for proper billing.
Vial Optimization ▸
2 Copay Assistance
Early access Medicaid estimates are newly added — verify with the plan.
Leave blank to show all foundations. When set, foundations with stricter income limits are hidden.
Original Medicare Part B (2026)
Deductible: $283 · Coinsurance: 80/20 · No OOP max.
Medicare patient: Manufacturer copay assistance programs are not available. Foundation programs may still apply.
3 Patient Benefits
Not applicable for Medicaid. Patient cost is calculated above. Deductible / OOP / coinsurance fields below do not apply to Medicaid plans (federal nominal copay framework).
Ded remaining$0.00
OOP remaining$0.00
Plan %
/
Patient %
+ Add Secondary Insurance
Secondary Insurance Remove
Tricare for Life — $0 Patient Responsibility
TRICARE for Life pays 100% of remaining balance after Medicare.
No secondary coverage. Patient responsibility based on primary benefits only.
Sec. ded remaining$0.00
Sec. OOP remaining$0.00
Plan %
/
Patient %
Assumed — click any to change:
Without Copay Assist
$0.00
with E&M
$0.00
without E&M
With Copay Assist
$0.00
with E&M
$0.00
without E&M
No copay assistance programs available.
3 Coverage Check — what the payer requires
The estimate above is what the patient owes. This is what the payer wants before it pays, for this drug — quoted from their own policy, with a link to it. Commercial plans only.
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