Free CVS Pharmacy Receipt Example – Prescription Pickup & OTC Item (Sample) receipt example

Prescription copay at $58.00 and Vitamin C tablets 100 count at $6.49 is what the two line items show, and you can edit the receipt to make one for a different CVS pharmacy purchase. Ninety two cents in Colorado sales tax plus a $1.10 Rx processing fee brings it to $66.51 on pharmacy transaction RX-771204, pharmacist L. Chen. CVS Pharmacy Store 5110 at 7700 W Colfax Ave, Lakewood, CO 80214. Fifty eight dollars for a prescription copay in Lakewood is on the higher end, which usually means the medication is a brand name that the insurance only covers at a specialty tier. Phone (303) 555-4490. The item names are editable. The prices are not locked in either. Different pharmacy, different prescription, different pharmacist. Edit the fields to make an editable receipt for a different visit. A generic copay of fifteen dollars or an antibiotic, the fields do not care. Visa ending in 7038 by chip. The bottom reads medication details may be abbreviated on printed receipts for privacy.