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Staples Record Book, Black, 300 Sheets/Book (217919)
Item #: 550-217919
Record book for keeping track of tons of information
Black cover with burgundy spine and corners features gold-stamped title for elegant look
Contains 300 numbered pages, faintly ruled with margin lines, 40 lines per page
$29.29
Per each
Medical Arts Press® Tamper-Resistant Laser Rx Paper; 2 RX Blanks/Sheet, High Security, 500/Pack (SECR1PLBK)
Item #: 901-83401
Security features exceed industry guidelines and meet all Medicaid requirements
Void pantograph - the word "VOID" appears when form is photocopied
Chemical protection - stains or spots appear with chemical alteration
Quill® Economy Columnar Pads for Prong Fasteners; 4 Columns, 50 Sheets/Pad, 10 Pads/Pack (95141)
Item #: 369-745804
20-lb. ledger green paper
50 numbered lines, every fifth horizontal line heavily ruled as line guide
10,000,000 units per column
$68.99
Per pack
($6.90/EACH)
Medical Arts Press® Progress Notes; Reinforced, Top Punched, 250/Pack (20555)
Item #: 369-20555
Provides plenty of room to record patient progress and your findings at subsequent visits
Record patient name, birth date and gender
Ruled back side
$84.99
Per pack
($0.34/EACH)
Medical Arts Press Invoices, 8-1/2" x 11", 500 Sets/Book, 500/Pack (30465A)
Item #: 369-30465A
Solid Color Style D Laser Statements
Size: 8.5 X 11 inch
500/Package
$42.99
Per pack
($0.09/EACH)
ComplyRight CMS-1500 Health Insurance Claim Forms (02/12), 8-1/2" x 11", Box of 1,000 (CMS12LC1)
Item #: 550-CMS12LC1
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$39.53
Per carton
($0.04/EACH)
Medical Arts Press Registration Forms without Updates Section ; Brush Silhouette
Item #: 369-21786
Comprehensive form gathers complete insurance information, making it easier for you to process claims
Silhouetted toothbrush design welcomes patients
Printed in 1-color on two sides on 24-lb. white bond paper
$56.29
Per pack
($0.23/EACH)
Adams 3-Part Carbonless Receipt Book, 10.88" x 7.63", 100 Sets/Book (TC1182)
Item #: 550-TC1182
Carbonless soft-cover money/receipt books for general receipts
Originals are white in color and copies are canary and pink in color and made of smooth carbonless paper for convenience
Contains one 100-receipt book per pack
$8.97
Per each
ComplyRight CMS-1500 Health Insurance Claims, 2500/Pack (CMS12LC)
Item #: 550-125557
Includes QR code identifier at the top of the form that supports and aligns with Industry scanning systems
Printed with OCR "dropout" red ink on 20lb. paper (per government regulations)
Includes new QR code identifier at the top of the form that supports and aligns with Industry scanning systems
$62.99
Per pack
($0.03/EACH)
Adams® Carbonless Receipt Book, 3" x 8", 2-Part, 200 Sets/Book (SC1182)
Item #: 550-SC1182
Rent receipt books for recording monthly financial payments
Carbonless paper creates white originals and canary duplicates
Four forms per page and 50 pages; 200 forms per book
$8.61
Per each
ComplyRight CMS-1500 Health Insurance Claim Form, 250/Box (CMS12LC250)
Item #: 550-CMS12LC250
Approved by the National Uniform Claim Committee (NUCC); HIPAA compliant
This form was revised to align the paper form with some of the changes in the electronic healthcare claims: Professional (837), 005010X222 Technical Report Type 3 (5010) and 005010X222A1 Technical Report Type 3 (5010A1)
The most significant change was the addition of 8 diagnosis codes in field 21
$32.82
Per box
($0.13/EACH)
Adams 2-Part Carbonless Receipt Book, 5" x 11", 200 Sets/Book (SC1152)
Item #: 550-SC1152
Money/rent receipt book for recording rent payments and other payments
White originals and canary duplicates and made of carbonless paper
Contains 200 receipts per book; four forms per page
$8.56
Per each
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New Customers
Adams 2-Part Carbonless Sales Orders, 8.44"L x 5.56"W, 50 Sets/Book (DC5805)
Item #: 550-196113
Sales and order books are ideal for keeping proper records of orders and sales
Business form size: 5.56"W x 8.44"L; detached: 5.56"W x 7.94"L
2-Part White/Canary Carbonless forms for accurate record keeping
$5.97
Per each
Staples Columnar Books, 100 Pages, 6 Columns, Green, 2/Pack (217869)
Item #: 550-217869
Columnar book is ideal for accounting and record keeping
Eye-ease green-tinted paper
Includes 100 single-format pages with 6 columns
$20.89
Per pack
($10.45/EACH)
Adams 2-Part Carbonless Sales Orders, 4.17"L x 7.2"W, 50 Sets/Book, 10/Box (DC4705-10)
Item #: 550-DC470510
Sales and order books are ideal for keeping proper records of orders and sales
Size: 7.19"L x 4.19"W
Features a carbonless 2-part format that allows you to keep a permanent copy for your records
$30.56
Per pack
($3.06/EACH)
Staples Ledger Book, Black, 150 Sheets/Book (217679)
Item #: 550-217679
This Ledger book provides a profession look while keeping track of all important transactions
Black cover with burgundy spine and corners
150 pages, faintly ruled with margin lines, 33 lines per page
$36.49
Per each
Rediform 2-Part Carbonless Driver's Daily Logs, 9.13"L x 5.5"W, 31 Sets/Book (REDS5031NCL)
Item #: 550-REDS5031NC
Driver's daily log book is providing plenty of space to record driving time
Size: 9.13"L x 5.5"W
Features 2-part format that allows you to keep a permanent copy for your records
$7.49
Per each
Adams 2-Part Carbonless Work Orders, 5.5625" x 8.4375", 10 Sets/Book, /Box (DC5805-10)
Item #: 369-DC580510
Sales orders book to keep accurate records
White pages to create originals and canary pages for copies
Pack of 10.
$89.99
Per pack
($9.00/EACH)
Medical Arts Press® Single Rx Blanks; Alter-Proof, Indiana, 1 Part
Item #: 901-16031P
Specifically designed to meet state requirements when prescribing controlled substances in Indiana
Printed on tamper-proof safety paper
Please specify doctor's name and State License and/or DEA numbers if desired
TOPS 3-Part Carbonless Bill of Lading, 8.5"L x 7"W, 50 Sets/Book (3841)
Item #: 550-3841
Bill of lading form to ensure all your shipments arrive with the appropriate paperwork
Size: 8.5"L x 7.63"W; detached: 8.5"L x 7"W
3-Part Carbonless forms for accurate record keeping
$9.26
Per pack
($0.19/EACH)
Delforms® One-Write General Expense Check Refills; 250 per Pack, without Duplicates
Item #: 901-111011
No messy carbon paper
Eliminates copy errors and saves time
Security features include erasure protection; micro-print signature line; chemical-sensitive paper; padlock icon and warning; security screen and warning box
Tabbies Patient Privacy Sign-In Sheets, 2-Part, 125/Pack (TAB14530)
Item #: 550-2678550
Confidentially sign in your patients with guest-check forms
Business-form size: 11.63"L x 8.5"W
2 Part Carbon
$54.97
Per pack
($0.44/EACH)
Medical Arts Press® Copy-Proof Rx Blanks; Carbonless Duplicate Books
Item #: 901-16019
6 security features comply with CMS 10/1/08 Tamper Resistant Requirements for Medicaid
Copy-proof Rx blanks feature a blue pattern background; "void" pantograph appears when copied
Micro-print signature line helps prevent counterfeiting and states security when viewed through a magnifying glass; security band lists security features
Medical Arts Press® Tamper-Resistant Laser Rx Paper; 1 RX Blank/Sheet, High Security, 500/Pack
Item #: 901-83405
Security features exceed industry guidelines and meet all Medicaid requirements
Void pantograph - the word "VOID" appears when form is photocopied
Chemical protection - stains or spots appear with chemical alteration
