| Number of Patches | Out-of-Pocket Cost | - | Copay Card Pays | = | You Pay |
| 1 | $250 | $230 | $20 | ||
| 2 | $500 | $480 | $20 | ||
| 3 | $900 | $880 | $20 | ||
| 4 | $1,300 | $1,200 | $100 |
*Program rules and eligibility provided on copay card.

©2022 Cumberland Pharmaceuticals Inc. All rights reserved.
Printed in U.S.A. PM-US-SAN-0047 April 2022