1-Part Pads (100 Scripts per Pad)
| Plain Paper - Portrait Orientation: 4.25" x 5.5" |
$45.00 |
$60.00 |
$72.00 |
$88.00 |
$102.00 |
$111.00 |
$156.00 |
| Tamper Resistant - (Approved for all Medicaid scripts) Portrait Orientation: 4.25" x 5.5" |
$56.00 |
$76.00 |
$91.00 |
$111.00 |
$133.00 |
$155.00 |
$195.00 |
| Sched. II CS-Compliant (CA Only) Landscape Orientation: 5.5"x 4.25" |
$109.00 |
$147.00 |
$195.00 |
$240.00 |
$275.00 |
$320.00 |
$474.00 |
| Sched. II CS-Compliant (WA / ME / IN / KY / WY) Landscape Orientation: 5.5"x 4.25" |
$61.00 |
$84.00 |
$101.00 |
$122.00 |
$147.00 |
$171.00 |
$217.00 |
| CA Multi-Drug Portrait Orientation: 4.25"x 7" |
$176.00 |
$252.00 |
$349.00 |
$439.00 |
$510.00 |
$600.00 |
|
| Add: Ground Shipping |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
Optional Add:
Sequential Numbers starts at 000001 |
$10.20 |
$13.60 |
$20.40 |
$30.60 |
$34.00 |
$40.80 |
$61.20 |
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
| Plain Paper - Portrait Orientation: 4.25" x 5.5" |
$62.00 |
$92.00 |
$120.00 |
$151.00 |
$181.00 |
$208.00 |
$289.00
|
| Tamper Resistant - (Approved for all Medicaid scripts) Portrait Orientation: 4.25" x 5.5" |
$72.00 |
$106.00 |
$146.00 |
$184.00 |
$219.00 |
$248.00 |
$328.00
|
| Sched. II CS-Compliant (CA Only) Landscape Orientation: 5.5"x 4.25" |
$156.00 |
$210.00 |
$270.00 |
$351.00 |
$435.00 |
$506.00 |
$713.00
|
| Sched. II CS-Compliant (WA / ME / IN / KY / WY) Landscape Orientation: 5.5"x 4.25" |
$85.00 |
$126.00 |
$172.00 |
$217.00 |
$258.00 |
$292.00 |
$385.00
|
| CA Multi-Drug Portrait Orientation: 4.25"x 7" |
$271.00 |
$337.00 |
$498.00 |
$662.00 |
$830.00 |
$972.00 |
|
| Add: Ground Shipping |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00
|
Optional Add:
Sequential Numbers starts at 000001 |
$10.20 |
$13.60 |
$20.40 |
$30.60 |
$34.00 |
$40.80 |
$61.20
|
1-Part Pads (100 Scripts per Pad)
| Advanced Practice Nurse |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
| Certified Nurse Midwife |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
| Physician Assistant |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
UPS Ground Shippping
Secure Signature Required |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
| Advanced Practice Nurse |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00
|
| Certified Nurse Midwife |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00
|
| Physician Assistant |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00
|
UPS Ground Shippping
Secure Signature Required |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00
|
1-Part Pads (100 Scripts per Pad)
| NJBP - Facilities |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
UPS Ground Shippping
Secure Signature Required |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
| NJBP - Facilities |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00 |
UPS Ground Shippping
Secure Signature Required |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
1-Part Pads (100 Scripts per Pad)
| NJPB - MD, DO, DDS/DMD, DPM, DVM/VMD/BVSc, OPT |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
| Optometry - Eyewear* |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
| Optometry - Blank* |
$97.00 |
$132.00 |
$175.00 |
$216.00 |
$248.00 |
$288.00 |
$426.00 |
UPS Ground Shippping
Secure Signature Required |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
| NJPB - MD, DO, DDS/DMD, DPM, DVM/VMD/BVSc, OPT |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00 |
| Optometry - Eyewear* |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00 |
| Optometry - Blank* |
$143.00 |
$179.00 |
$256.00 |
$335.00 |
$414.00 |
$483.00 |
$683.00 |
UPS Ground Shippping
Secure Signature Required |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
1-Part Pads (100 Scripts per Pad)
| Premium Security - (Meets or exceeds security requirements in all states) Landscape Orientation: 5.5" x 4.25" |
$66.00 |
$91.00 |
$109.00 |
$133.00 |
$159.00 |
$186.00 |
$234.00 |
| Add: Ground Shipping |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
Optional Add:
Sequential Numbers starts at 000001 |
$10.20 |
$13.60 |
$20.40 |
$30.60 |
$34.00 |
$40.80 |
$61.20 |
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
| Premium Security - (Meets or exceeds security requirements in all states) Landscape Orientation: 5.5" x 4.25" |
$85.00 |
$126.00 |
$172.00 |
$217.00 |
$258.00 |
$292.00 |
$385.00 |
| Add: Ground Shipping |
$21.00 |
$22.00 |
$23.00 |
$25.00 |
$27.00 |
$29.00 |
$32.00 |
Optional Add:
Sequential Numbers starts at 000001 |
$10.20 |
$13.60 |
$20.40 |
$30.60 |
$34.00 |
$40.80 |
$61.20 |