CVS Pharmacy Receipt Example
This is a sample CVS Pharmacy receipt showing Prescription Co-Pay, Ibuprofen 200mg 100ct and 1 more item, with a total of $32.99. Use it as a reference for what a real CVS Pharmacy receipt looks like — then make your own with your items, prices, date and store details.
What's on this receipt
| Item | Qty | Price |
|---|---|---|
| Prescription Co-Pay | 1 | $10.00 |
| Ibuprofen 200mg 100ct | 1 | $8.99 |
| Vitamin D3 | 1 | $12.49 |
| Total (incl. tax) | $32.99 | |
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SALES RECEIPT
CVS Pharmacy
910 Health Plaza Drive
Woonsocket, RI 02895
(303) 555-0155
06/15/2026 13:42 · Receipt #855399
Store # 100Reg 1
| Item | Qty | Price | Total |
|---|---|---|---|
| Prescription Co-Pay | 1 | $10.00 | $10.00 |
| Ibuprofen 200mg 100ct | 1 | $8.99 | $8.99 |
| Vitamin D3 | 1 | $12.49 | $12.49 |
Subtotal$31.48
Sales Tax (4.81%)$1.51
TOTAL$32.99
Payment MethodCredit •••• 4821
Your health, our priority.
855399