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Price List for the tamper-resistant California Security Rx

Form Single
Rx Pads S-425 S-800 S-850
100 2 $45
500 10 $70 $110 $150
1000 20 $110 $160 $200
2500 50 $195 $225 $275
5000 100 $295 $325 $350

Form Carbonless Duplicate
Rx Pads D-425 D-800 D-850
500 10 $115 $150 $200
1000 20 $175 $200 $250
2500 50 $295 $350 $450
5000 100 $475 $500 $600

Form Laser Printer
Rx L-110
500 $115
1000 $195
2500 $315
5000 $450

Above is the price for California Security Prescription. Price for the Medicaid Tamper-Resistant prescription is listed (Medicaid Tamper Resistant Rx Price).

* RUSH ORDERS AVAILABLE (1-2 business days, call for service fee).

* For Regular Prescription Pads, Please call 1-877-290-4262 for details.


Guaranteed Lowest Prices: If you find a lower price for a comparable product, fax the invoice and we will match that price.
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Description of California Security Prescription Forms:
S- Single Form: Individual (1-part) prescriptions; 50 Rx per Pad.
D- Carbonless Duplicate Form: 2-part prescriptions with a yellow copy with the imprint of the prescription. 50 Rx per booklet (100 sheets) with a wrap around cover.
L- Laser Printer Form: Individual (1-part) prescriptions for use in laser or ink jet printers. The provider information is imprinted on each prescription.
R1 Format: Starting Jan 2006, State Law 734, requires the single medication per prescription to be phased out. With the modified R1 Format you can write more than one medications per prescription, however the prescription is not partitioned.
R3 Format: Allows you to write three medications per prescription with individual space and quantity check off boxes for each medication.
Prescription Size: S-425 & D-425 is 4.25"x 5.5".
Prescription Size: S-800 & D-800 is 8" x 3.5".
Prescription Size: S-850 & D-850 is 8" x 5.5".
Prescription Size: L-110 is 8.5" x 11" with one prescription per page.
*The carbonless duplicate has an imprint of the Rx form for better record keeping.
*Prescriptions can include multiple physicians or multiple practice sites (there is a one time $10 for each additional entry set up fee).
*Logos can be added ($25 set up fee).
*Price does not include Tax and Shipping. An invoice with the total cost will be mailed to you with your order.
*Prices are subject to change.
For pricing on large orders please contact American Security RX at 877-290-4262.
Tamper-resistant Prescription Pads
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