Page 4 of hcfa cms 1500 health insurance business forms
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Accounting & Record Journals (104) -
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Medical Arts Press® Mounting Sheets; All-Purpose, Adhesive Strip
Item #: 901-20252NP
Item #: 901-20252NP
Medical Arts Press® Take Home Instructions
Item #: 901-13870M
Item #: 901-13870M
125 sheets per pack
Form size: 8-1/2" x 11"
Custom Registration Forms, 8-1/2" x 11", 250 Sheets per Pack
Item #: 901-QFN105XX1R
For use in patient charts
8-1/2" W x 11" L
White 20# text stock with preprinted template; custom imprint printed in black ink
Staples Columnar Books, 100 Pages, Green, 2/Pack (217844ABF)
Item #: 901-217844
Item #: 901-217844
Columnar book is ideal for accounting and record keeping
Eye-ease green-tinted paper
Includes 100 single-format pages with 4 columns
Quill® Economy Columnar Pads for Prong Fasteners; 4 Columns, 50 Sheets/Pad, 10 Pads/Pack (95141)
Item #: 901-745804
Item #: 901-745804
20-lb. ledger green paper
50 numbered lines, every fifth horizontal line heavily ruled as line guide
10,000,000 units per column
Staples Columnar Books, 100 Pages, 6 Columns, Green, 2/Pack (217869)
Item #: 901-217869
Item #: 901-217869
Columnar book is ideal for accounting and record keeping
Eye-ease green-tinted paper
Includes 100 single-format pages with 6 columns
Staples Laser Forms Double Window Envelopes, Wove White, 500/Box (ST473949-CC)
Item #: 901-473949STP
Item #: 901-473949STP
Business envelopes are suitable for many mailing projects
Made from white 24 lb. paper for durability
These envelopes measure 4 1/5"H x 9"L in size, providing enough space for your mail
Medical Arts Press® Tamper-Resistant Personalized Laser Rx Paper; Secure
Item #: 901-10719
Item #: 901-10719
Verification Box - Hold marked area between thumb and forefinger, or breathe on heat-sensitive box, the color will disappear, then reappear
Coin Reactant Ink - Rub the Rx mark on left with a coin. Ink will turn from white to gray
MicroPrint - The right and left side rules of the large box on the front have the word "security" in microPrint. Can be viewed with magnifying glass
Staples 13 Columns Columnar Book, 16.31"W x 11"H, Green (217893)
Item #: 901-217893
Item #: 901-217893
Green tinted paper
Includes 50 single-format pages with 13 columns
Overall dimensions: 16.31"W x 11"H
Medical Arts Press® Progress Notes, Includes Name, Sex, Birthdate and Page Number
Item #: 901-20541NP
Item #: 901-20541NP
Type of form: Progress note
250 per pack
Size: 8 1/2" x 11"
Quill Brand® Special-Size 3 Part Carbonless Forms, 9-1/2x5-1/2", 1,000/CT (9353)
Item #: 901-710837
Item #: 901-710837
Use Quill Brand special-size multi-part carbonless forms when you need multiple copies of the same form
Size: 9-1/2x5-1/2"; 8-1/2x5-1/2" without the carrier strips
3-part forms: white top sheet, canary-colored second sheet and pink third sheet
Medical Arts Press Narrow Ruled Veterinary Animal Record Progress Notes (20474)
Item #: 901-20474
Item #: 901-20474
Form heading includes space for owner s information and animal s identifying information
Top of page reinforced and two-hole punched
Reverse side is printed with Date and Progress Notes column headings
Staples Ledger Book, Black, 150 Sheets/Book (217679)
Item #: 901-217679
Item #: 901-217679
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
Quill Brand® Columnar Book, 3-Columns, 80 Pages, Blue Marble (18847/26516)
Item #: 901-217737
Item #: 901-217737
Columnar book for record keeping
Blue marble and made of paper
Includes 80 single-format pages, comes with three columns per page, quad-ruled, 30 lines down per page
Quill Brand® 9.5" x 11" Continuous Form Paper, 18 lbs., 92 Brightness 2550 Sheets/Carton (710608)
Item #: 901-710608
Item #: 901-710608
Continuous form bond paper
Paper weight: 18 lbs.
Size: 9-1/2x11" (8-1/2" width with carrier strips removed)
Staples® Columnar Books, 100 Pages, Green, 2/Pack (217851ABF)
Item #: 901-217851
Item #: 901-217851
Columnar book is ideal for accounting and record keeping
Eye-ease green-tinted paper
Includes 100 single-format pages with 5 columns
Medical Arts Press Mounting Sheets; Prescriptions, Adhesive Strip, Two Hole Punched
Item #: 901-20255NP
Item #: 901-20255NP
Keep patient records organized and accessible.
Use for storing duplicates of prescriptions in patient's chart.
Adhesive strips hold up to 10 prescriptions.
Staples Record Book, 300 Pages, Black (18658/26510)
Item #: 901-217695
Item #: 901-217695
Record book for keeping track of tons of information
Black cover with burgundy spine and corners for elegant look
Contains 300 numbered pages, faintly ruled with margin lines; 33 lines per page
Medical Arts Press® Tamper-Resistant Laser RX Blanks; 1 RX Blank/Sheet, Indiana
Item #: 901-PRES1LIN
Item #: 901-PRES1LIN
Blank Format, Top Left Location
Meets Indiana Requirements
Security Features include: blue void pantograph, security backprinting, reverse Rx symbox, checkboxes
Staples Columnar Book, 50 Pages, Green (217885)
Item #: 901-217885
Item #: 901-217885
Columnar book is ideal for accounting and record keeping
Green-tinted paper with green and black lines
Includes 50 pages with 12 columns
Staples Record Book, 7.25" x 11.75", Black/Burgundy (ST26513)
Item #: 901-217687
Item #: 901-217687
Keep records, create lists, and write other notes with this classic-look journal
Black hardcover with a burgundy spine and corners
Contains 150 numbered, wide ruled 7.25"W x 11.75"H pages, while blue and red lines make it easy to keep writing organized on each sheet
Quill Brand® 9.5" x 11" 4 Part Form Paper, 15 lbs., 92 Brightness, 850 Sheets/Carton (710754)
Item #: 901-710754
Item #: 901-710754
4-part form paper produces letter-size originals and three copies fast and fuss-free
Paper weight: 15 lb. white top sheet, 15 lb. bottom sheets
8-1/2x11" without carrier strips (9-1/2x11" with 1/2" standard perforated carrier strips)
Medical Arts Press Invoices, 8-1/2" x 11", 500 Sets/Book, 510/Pack (19906B)
Item #: 901-19906B
Item #: 901-19906B
Features Visa, Mastercard, Discover & American Express Logos
Easy-Tear Perforation Allows Top To Be Detached & Returned with Payment
Perforation Is 3.68 From top Of Statement
Quill Brand® While You Were Out Book, 11" x 8-1/4", Assorted, 400 Forms/Book (745414)
Item #: 901-745414
Item #: 901-745414
Phone message books simplify call and message tracking in the office
Size: 11" x 8-1/4"
100 Sheets per pad with 4 perforated forms per page
$16.29
Per each
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