$24 or less in 24 hours
For each qualifying medication
ALL PATIENTS ELIGIBLE
FREE DELIVERY
NO PRIOR-AUTHORIZATION
PRESCRIBE
BAYBRIDGE PHARMACY
208-48 CROSS ISL AND PKWY
BAYSIDE, NY 11360
P : (718) 751-9911 *
F: (718) 751-9922
NPI : 1235732926
* Text or Call
CENTRAL PHARMACY
121 KENT AVE
BROOKLYN, NY 11249
P : (929) 397-0331 *
F : (929) 397-0332
NPI : 1003419334
* Text or Call
PRO PHARMACY
71 E OLD COUNTRY RD
HICKSVILLE, NY 11801
P : (516) 719-5919 *
F : (516) 719-5920
NPI : 1013510353
* Text or Call
CONFIRM
DELIVER
OUR FORMULARY
GENERIC FORMULARY
NSAIDs
CELECOXIB 50mg, 100mg, 200mg Capsules
DICLOFENAC 50mg, 75mg DR Tablets
IBUPROFEN 200mg, 400mg, 600mg, 800mg Tablets
INDOMETHACIN 25mg, 50mg Capsules
INDOMETHACIN 75mg SR Capsules
MELOXICAM 75mg, 15mg Tablets
NABUMETONE 500mg, 750mg Tablets
NAPROXEN 220mg, 250mg, 375mg, 500mg Tablets
SULINDAC 150mg, 200mg Tablets
DICLOFENAC 50mg, 75mg DR Tablets
IBUPROFEN 200mg, 400mg, 600mg, 800mg Tablets
INDOMETHACIN 25mg, 50mg Capsules
INDOMETHACIN 75mg SR Capsules
MELOXICAM 75mg, 15mg Tablets
NABUMETONE 500mg, 750mg Tablets
NAPROXEN 220mg, 250mg, 375mg, 500mg Tablets
SULINDAC 150mg, 200mg Tablets
TOPICALS
CAPSAICIN 0.1% Cream 60g
DICLOFENAC 1% Gel 100g
DICLOFENAC 1.5% Topical Solution 150ml
LIDOCAINE 4% Cream 4.7oz
LIDOCAINE 4%, 5% Patches 10ct
LIDOCAINE 5% Ointment 50g
LIDOCAINE/MENTHOL 4-1% Cream 2.7oz
LIDOCAINE/MENTHOL 4-1% Patches 10ct
LIDOCAINE/MENTHOL 4-1% Spray 4oz
LIDOCAINE/PRILOCAINE 2.5-2.5% Cream 30g
MENTHOL 2.5% Gel 2.5oz
MENTHOL 16% Gel 1.75oz
MENTHOL 7.5% Patch 8ct
MENTHOL 16% Spray 4oz
MENTHOL/METHYL SALICYLATE Cream 3oz
DICLOFENAC 1% Gel 100g
DICLOFENAC 1.5% Topical Solution 150ml
LIDOCAINE 4% Cream 4.7oz
LIDOCAINE 4%, 5% Patches 10ct
LIDOCAINE 5% Ointment 50g
LIDOCAINE/MENTHOL 4-1% Cream 2.7oz
LIDOCAINE/MENTHOL 4-1% Patches 10ct
LIDOCAINE/MENTHOL 4-1% Spray 4oz
LIDOCAINE/PRILOCAINE 2.5-2.5% Cream 30g
MENTHOL 2.5% Gel 2.5oz
MENTHOL 16% Gel 1.75oz
MENTHOL 7.5% Patch 8ct
MENTHOL 16% Spray 4oz
MENTHOL/METHYL SALICYLATE Cream 3oz
MEDICATION ASSISTED THERAPY (MAT)
BUPRENORPHINE 2mg, 8mg Tablets
MIGRAINE RELIEF
BUT/APAP/CAFFEINE 50mg-325mg-40mg Tablets
PROPRANOLOL 10mg, 20mg, 40mg, 80mg Tablets
RIZATRIPTAN 5mg, 10mg Tablets
RIZATRIPTAN 5mg, 10mg ODT Tablets
SUMATRIPTAN 25mg, 50mg, 100mg Tablets
TOPIRAMATE 25mg, 50mg, 100mg, 200mg Tablets
ZOLMITRIPTAN 2.5mg, 5mg Tablets
PROPRANOLOL 10mg, 20mg, 40mg, 80mg Tablets
RIZATRIPTAN 5mg, 10mg Tablets
RIZATRIPTAN 5mg, 10mg ODT Tablets
SUMATRIPTAN 25mg, 50mg, 100mg Tablets
TOPIRAMATE 25mg, 50mg, 100mg, 200mg Tablets
ZOLMITRIPTAN 2.5mg, 5mg Tablets
ANTIMUSCARINICS / ANTISPASMODICS
DICYCLOMINE 10mg Capsules
DICYCLOMINE 20mg Tablets
GLYCOPYRROLATE 1mg, 2mg Tablets
HYOSCYAMINE 0.125mg Sublingual Tablets
HYOSCYAMINE 0.125mg/ml Solution
DICYCLOMINE 20mg Tablets
GLYCOPYRROLATE 1mg, 2mg Tablets
HYOSCYAMINE 0.125mg Sublingual Tablets
HYOSCYAMINE 0.125mg/ml Solution
MUSCLE RELAXANTS
CYCLOBENZAPRINE 5mg, 10mg Tablets
METHOCARBAMOL 500mg, 750mg Tablets
METAXALONE 800mg Tablets
TIZANIDINE 2mg, 4mg Tablets
METHOCARBAMOL 500mg, 750mg Tablets
METAXALONE 800mg Tablets
TIZANIDINE 2mg, 4mg Tablets
SNRI
DULOXETINE 20mg, 30mg, 60mg DR Capsules
VENLAFAXINE 25mg, 37.5mg, 50mg, 75mg, 100mg Tabs
VENLAFAXINE 37.5mg, 75mg, 150mg ER Capsules
VENLAFAXINE 25mg, 37.5mg, 50mg, 75mg, 100mg Tabs
VENLAFAXINE 37.5mg, 75mg, 150mg ER Capsules
ATYPICAL
BUPROPION 75mg, 100mg Tablets
BUPROPION 100mg, 150mg ER Tablets
BUPROPION 150mg, 300mg XL Tablets
BUPROPION 200mg SR Tablets
MIRTAZAPINE 15mg, 30mg, 45mg Tablets
TRAZODONE 50mg, 100mg Tablets
BUPROPION 100mg, 150mg ER Tablets
BUPROPION 150mg, 300mg XL Tablets
BUPROPION 200mg SR Tablets
MIRTAZAPINE 15mg, 30mg, 45mg Tablets
TRAZODONE 50mg, 100mg Tablets
ANTICONVULSANTS
CARBAMAZEPINE 200mg Tablets
GABAPENTIN 100mg, 300mg, 400mg Capsules
GABAPENTIN 600mg, 800mg Tablets
LAMOTRIGINE 25mg, 100mg, 150mg, 200mg Tablets
OXCARBAZEPINE 150mg, 300mg Tablets
PREGABALIN 25mg, 50mg, 75mg Capsules
PREGABALIN 150mg, 220mg, 225mg, 300mg Capsules
GABAPENTIN 100mg, 300mg, 400mg Capsules
GABAPENTIN 600mg, 800mg Tablets
LAMOTRIGINE 25mg, 100mg, 150mg, 200mg Tablets
OXCARBAZEPINE 150mg, 300mg Tablets
PREGABALIN 25mg, 50mg, 75mg Capsules
PREGABALIN 150mg, 220mg, 225mg, 300mg Capsules
SSRI
CITALOPRAM 10mg, 20mg, 40mg Tablets
ESCITALOPRAM 5mg, 10mg, 20mg Tablets
FLUOXETINE 10mg, 20mg, 40mg Capsules
FLUVOXAMINE 25mg, 50mg, 100mg Tablets
PAROXETINE 10mg, 20mg, 30mg, 40mg Tablets
SERTRALINE 25mg, 50mg, 100mg Tablets
ESCITALOPRAM 5mg, 10mg, 20mg Tablets
FLUOXETINE 10mg, 20mg, 40mg Capsules
FLUVOXAMINE 25mg, 50mg, 100mg Tablets
PAROXETINE 10mg, 20mg, 30mg, 40mg Tablets
SERTRALINE 25mg, 50mg, 100mg Tablets
TCA
AMITRIPTYLINE 10mg, 25mg Tablets
DOXEPIN 10mg, 25mg Capsules
IMIPRAMINE 10mg, 25mg, 50mg Tablets
NORTRIPTYLINE10mg, 25mg, 50mg, 75mg Capsules
DOXEPIN 10mg, 25mg Capsules
IMIPRAMINE 10mg, 25mg, 50mg Tablets
NORTRIPTYLINE10mg, 25mg, 50mg, 75mg Capsules
The terms of, and medications offered by, Sparta Dermatology are subject to change at the discretion of Sparta Rx, LLC. Trade size dispensed of medications offered at $24 or less may vary. All patients eligible; commercially insured, uninsured, and those with Medicaid/Medicare. April 2021 Sparta Rx Programs (Care)
BRAND FORMULARY
NSAIDs
| Cost | |
|---|---|
| CELEBREX 50mg, 100mg, 200mg Capsules | $4 |
| DUEXIS 800mg-26.6mg Tablets | $0 |
| FENOPROFEN 200mg, 400mg Capsules | $0 |
| NAPROSYN (NAPROXEN) 125mg/5ml Oral Suspension | $0 |
| NAPROXEN 375mg, 500mg Controlled Release Tablets | $0 |
| VIMOVO 375mg-20mg, 500mg-20mg Delayed Release Tablets | $0 |
| TIVORBEX (INDOMETHACIN) 20mg Capsules | $10 |
| ZIPSOR 25mg Capsules | $15 |
MUSCLE RELAXANTS
| Cost | |
|---|---|
| CHLORZOXAZONE 250mg, 375mg, 500mg Tablets | $0 |
| CYCLOBENZAPRINE 7.5mg Tablets | $0 |
| METAXALONE 400mg Tablets | $0 |
| RELAFEN DS 1000mg Tablets | $0 |
ANTIMUSCARINICS / ANTISPASMODICS
| Cost | |
|---|---|
| GLYCOPYRROLATE 1.5mg Tablets | $0 |
FIBROMYALGIA / NERVE PAIN
| Cost | |
|---|---|
| LYRICA 25mg, 50mg, 75mg, 100mg, 150mg, 200mg, 225mg, 300mg Caps | $4 |
| GRALISE 300mg, 600mg Tablets | $28 |
| SAVELLA 12.5mg, 25mg, 50mg, 100mg Tablets | $40 |
MIGRAINE RELIEF - INJECTION
| Cost | |
|---|---|
| AIMOVIG 70mg, 140mg Injection | $0-$5 |
| AJOVY 225mg Injection | $5 |
| EMGALITY 120mg Injection | $0 |
MIGRAINE RELIEF - NASAL SPRAY
| Cost | |
|---|---|
| DIHYDROERGOTAMINE Nasal Spray 4mg (Compared to Migranal | $0-$15 |
| TOSYMRA 10mg Nasal Spray | $0 |
| ZOMIG 2.5mg Nasal Spray | $25 |
MIGRAINE RELIEF - BY MOUTH
| Cost | |
|---|---|
| ALLZITAL 25mg/325mg Tablets (Butalbital/Acetaminophen) | $0 |
| CAMBIA 50mg Packets | $0 |
| ORPHENADRINE/ASPIRINE/CAFFEINE 50mg/770mg/60mg Tabs | $0 |
| NURTEC 75mg ODT Tablets | $0 |
| REYVOW 50mg, 100mg Tablets | $0 |
| UBRELVY 50mg, 100mg Tablets | $10 |
TOPICALS
| Cost | |
|---|---|
| FLECTOR 1.3% Patch 30ct | $4 |
| PENETRAL Cream 8oz | $0 |
| PENNSAID 2% Topical Solution | $0 |
| PLIAGLIS Cream 30g (Lidocaine 7%/Tetracaine 7%) | $0-$15 |
WOUND CARE
| Cost | |
|---|---|
| KAMDOY Skin Emulsion | $0 |
| LIDOTREX Wound Gel 28.33g (Lidocaine 2%/Collagen 1.2%/Aloe Vera 1%) | $0 |
MEDICATION ASSISTED THERAPY (MAT)
| Cost | |
|---|---|
| BUPRENORPHINE/NALOXONE 2mg/0.5mg ODT Tablets | $0-$30 |
| BUPRENORPHINE/NALOXONE 8mg/2mg ODT Tablets | $0-$30 |
| BUPRENORPHINE/NALOXONE 2mg/0.5mg Film | $0-$30 |
| BUPRENORPHINE/NALOXONE 4mg/1mg Film | $0-$30 |
| BUPRENORPHINE/NALOXONE 12mg/3mg Film | $0-$30 |
| BUPRENORPHINE 5mcg/hr, 7.5mcg/hr TD Patch | $0-$30 |
| BUPRENORPHINE 10mcg/hr TD Patch | $0-$30 |
| BUPRENORPHINE 20mcg/hr TD Patch | $0-$30 |
| SUBOXONE 2mg/0.5mg SL Film | $5 |
| SUBOXONE 4mg/1mg SL Film | $5 |
| SUBOXONE 12mg/3mg SL Film | $5 |
| ZUBSOLV All Strengths SL Tablets | $10 |
This reference is intended for informational purposes only. Prices may vary at the discretion of the manufacturer or with
high deductible plans. Administered by Sparta Rx LLC, an Optio Rx Company. April 2021 Sparta Rx Programs (Care)
high deductible plans. Administered by Sparta Rx LLC, an Optio Rx Company. April 2021 Sparta Rx Programs (Care)
FAQS
FOR PATIENTS
Why use Sparta INSTEAD OF MY PHARMACY?
With us, there are no surprises. $24 or less in 24 hours!
Am I eligible?
Yes! Everyone is eligible – the uninsured, commercially insured, and those with medicare/medicaid.
What’s the catch?
There is none! It’s free! No membership. No sign-up. No pre-qualification.
What if I have a high copay or deductible?
No problem! We guarantee your out-of-pocket expense will never exceed $24!
My doctor just sent in a prescription, now what?
Hang tight – we will call or text you shortly to confirm your information and schedule delivery. Feel free to contact us too!
When and where do I get my medication?
You will receive your medication within 24 hours – we hand-deliver to most areas of New York, New Jersey, and Connecticut!
FOR PATIENTS
WHY USE SPARTA RX PROGRAMS INSTEAD OF MY PHARMACY?
With us, there are no surprises. $24 or less in 24 hours!
Am I eligible?
Yes! Everyone is eligible – the uninsured, commercially insured, and those with medicare/medicaid.
What’s the catch?
There is none! It’s free! No membership. No sign-up. No pre-qualification.
What if I have a high copay or deductible?
No problem! We guarantee your patient’s out-of-pocket expense will never exceed $24!
My doctor just sent in a prescription, now what?
Hang tight – we will call or text your patient shortly to confirm your information and schedule delivery. Feel free to contact us too!