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All Other States

1-Part Pads (100 Scripts per Pad)
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
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 $15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
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)
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
Plain Paper - Portrait Orientation: 4.25" x 5.5" $57.00 $83.00 $106.00 $133.00 $158.00 $181.00 $248.00
Tamper Resistant - (Approved for all Medicaid scripts) Portrait Orientation: 4.25" x 5.5" $67.00 $97.00 $132.00 $166.00 $196.00 $221.00 $287.00
Sched. II CS-Compliant (CA Only) Landscape Orientation: 5.5"x 4.25" $156.00 $189.00 $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" $74.00 $107.00 $144.00 $183.00 $216.00 $244.00 $316.00
CA Multi-Drug Portrait Orientation: 4.25"x 7" $271.00 $337.00 $498.00 $662.00 $830.00 $972.00
Add: Ground Shipping $15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
Optional Add:
Sequential Numbers starts at 000001
$10.20 $13.60 $20.40 $30.60 $34.00 $40.80 $61.20
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NJ APN, PA, and Midwife

1-Part Pads (100 Scripts per Pad)
New Jersey
Pad Type
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
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
$15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
New Jersey
Pad Type
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
Advanced Practice Nurse $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
Certified Nurse Midwife $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
Physician Assistant $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
UPS Ground Shippping
Secure Signature Required
$15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
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NJPB Facilities

1-Part Pads (100 Scripts per Pad)
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
NJBP - Facilities $97.00 $132.00 $175.00 $216.00 $248.00 $288.00 $426.00
UPS Ground Shippping
Secure Signature Required
$15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
NJBP - Facilities $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
UPS Ground Shippping
Secure Signature Required
$15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
Download PDF Order Online

NJPB - MD, DO, DDS/DMD, DPM, DVM/VMD/BVSc, OPT

1-Part Pads (100 Scripts per Pad)
New Jersey
Pad Type
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
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
$15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
2-Part Pads (50 Scripts per Pad with Carbonless Duplicate)
New Jersey
Pad Type
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
NJPB - MD, DO, DDS/DMD, DPM, DVM/VMD/BVSc, OPT $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
Optometry - Eyewear* $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
Optometry - Blank* $138.00 $170.00 $242.00 $317.00 $391.00 $456.00 $642.00
UPS Ground Shippping
Secure Signature Required
$15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
Download PDF Order Online

All Other States Premium Security

1-Part Pads (100 Scripts per Pad)
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
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 $15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
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)
8
Pads
16
Pads
24
Pads
32
Pads
40
Pads
48
Pads
72
Pads
Premium Security - (Meets or exceeds security requirements in all states) Landscape Orientation: 5.5" x 4.25" $80.00 $117.00 $158.00 $199.00 $235.00 $265.00 $344.00
Add: Ground Shipping $15.50 $16.75 $17.00 $17.50 $18.00 $19.00 $23.50
Optional Add:
Sequential Numbers starts at 000001
$10.20 $13.60 $20.40 $30.60 $34.00 $40.80 $61.20
Download PDF Order Online

EMR Laser Paper 8-1/2" x 11" NJPB MD-DO 1-up with perf

EWNJ1000
1000
Sheets
(0.4 carton)
EWNJ2500
2500
Sheets
(1 carton)
EWNJ5000
5000
Sheets
(2 carton)
EWNJ10000
10,000
Sheets
(4 carton)
Per Carton Price $144.45 $312.98 $597.10 $1,113.50
Shipping Price $15.00 $18.50 $32.00 $53.00
Download PDF Order Online

EMR Laser Paper 8-1/2" x 11" Medicaid-Compliant 1-up

EWNJ1000
1000
Sheets
(0.4 carton)
EWNJ2500
2500
Sheets
(1 carton)
EWNJ5000
5000
Sheets
(2 carton)
EWNJ10000
10,000
Sheets
(4 carton)
Per Carton Price $91.00 $195.00 $373.00 $662.00
Shipping Price
(Available to 48 contiguous states only)
$19.00 $29.50 $54.00 $99.00
Download PDF Order Online

EMR Paper 8-1/2" x 11" California CS-II 1-up

EWNJ1000
1000
Sheets
(0.4 carton)
EWNJ2500
2500
Sheets
(1 carton)
EWNJ5000
5000
Sheets
(2 carton)
EWNJ10000
10,000
Sheets
(4 carton)
Per Carton Price $207.00 $451.00 $858.00 $1,604.00
Shipping Price
(Available to 48 contiguous states only)
$26.00 $38.50 $71.00 $135.00
*TPA/OM Certification Number Required for Optometry NJPBs