RIVELSA TABLET
FDA nonproprietary name: levonorgestrel/ethinyl estradiol and ethinyl estradiol
For 1 unit (EA)
Pharmacies pay
$1.37 filed
1 × $1.37118 per EA
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
Medicare
We don’t know yet
No Medicare reference price. Part D: The Part D file flags this drug’s average spending per dosage unit as an outlier, so OpenBill does not use it as a reference price. Part B: This NDC is not in the current quarter’s Medicare Part B NDC-HCPCS crosswalk, so it has no Part B payment limit.
The spread
We don’t know yet
There is no Medicare figure to compare with, so there is no spread.
Cost-plus estimate
$6.58 estimated
$1.37 + $0.21 (15%) + $5.00 fee per fill = $6.58
This is a model, not a price any pharmacy quoted. Shipping is not included. For a pack this cheap, the $5.00 fee is most of the estimate. How it is worked out
OpenBill calculation · nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17)
Open the interactive card Change the quantity, type what you were charged, and see every record in full.
What it is
RIVELSA TABLET is how the CMS NADAC file names this product. The FDA NDC Directory lists it as levonorgestrel/ethinyl estradiol and ethinyl estradiol, under the trade name “Rivelsa”.
FDA gives its dosage form as kit.
The labeler, the company named on the label, is Teva Pharmaceuticals USA, Inc.
FDA lists no Established Pharmacologic Class for it.
The NADAC file of 2026-10-14 prices it under 2 NDCs (National Drug Codes); the FDA directory lists 1 of them.
NADAC classes it as a generic drug (rate-setting class G), and does not mark it as sold over the counter.
What pharmacies pay
Pharmacies pay $1.37 for 1 unit (EA) (1 × $1.37118 per EA, rounded to the cent), by the CMS NADAC file of 2026-10-14; that price took effect on 2026-09-23. That is what pharmacies pay their suppliers, not what they charge you.
NADAC’s explanation codes for it: 1, calculated from the most recently completed pharmacy survey; 6, the CMS Covered Outpatient Drug Product File S/I/N drug category was not applied when grouping drugs for the calculation.
What NADAC measures · NADAC explanation codes
All 2 NDCs
- 00093-6031-82 · Teva Pharmaceuticals USA, Inc. · $1.37118 per EA · eff. 2026-09-23 filed
- 00093-6031-91 · not listed as a package in the FDA directory · $1.37118 per EA · eff. 2026-09-23 filed
Other strengths, forms and brands
2 other products in the NADAC file share the FDA nonproprietary name levonorgestrel/ethinyl estradiol and ethinyl estradiol with RIVELSA TABLET.
| Product | Pharmacies pay per unit | Medicare per unit |
|---|---|---|
| CAMRESE LO TABLET | $0.23385 per EA filed | $1.08956 per EA filed |
| LOJAIMIESS 0.1-0.02-0.01 TAB | $0.23385 per EA filed | $0.58376 per EA filed |
| RIVELSA TABLET this page | $1.37118 per EA filed | We don’t know yet |
Part D is one average per brand and generic name, over every strength and form.
CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17
Medicare Part D · DSD_PTD_RY26_P04_V10_DY24_BGM.csv · eff. 2024-01-01 to 2024-12-31 · as of 2026-06-25 · retrieved 2026-10-18
What Medicare paid
We don’t know yet; the card above says why.
Which Medicare figure OpenBill compares · How Part D is matched · How Part B is matched
What to ask at the counter
None of these figures is your price: what you pay depends on your pharmacy, your insurance, coupons and discounts.
- What is your cash price for 1 unit (EA)? Is it lower than what I would pay through my insurance?
- These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.
Questions
- Why does this page start at 1 unit (EA)?
- NADAC prices this product per EA, and the FDA NDC Directory lists 1 of its 2 NDCs (it does not list the other one) as dosage form “KIT” with no route. Only a tablet, capsule, lozenge or troche with route “ORAL”, or a tablet or film with route “SUBLINGUAL” or “BUCCAL”, starts at 30, and this is not one. NADAC’s EA for it may be the whole kit or one item in it, and the files do not say which. So the card starts at 1 unit (EA) rather than guess how many make up a fill; change it to match your prescription.