Page 28 of replacement superbill forms
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Custom 2-Sided Progress Notes, 8-1/2" x 11", 24# White Text Stock, 250 Sheets per Pack
Item #: 901-QFN106411R
For use in patient charts
8-1/2" W x 11" L
White 20# text stock; printed in black ink
Custom Sales Book, Classic Design, Med Format, Your Custom Wording, 3 Parts, 1 Color Printing, 4 3/16" x 7", 500/Pack
Item #: 901-D2509SW3C
Take complete orders: Preprinted areas simplify write-ups of customer information, salesperson, description of items, payment method & more
Get the details: 12 lines provide ample room so orders can fit on a single page
Stay organized: Bottom copy stays bound in book for a permanent record; 50 sets per book
Custom Shipping Invoices, Classic Design, Small Format,2 Parts, 1 Color Printing, 8 1/2" x 7", 500/Pack
Item #: 901-D1052
Generous description area: 10 description lines with plenty of space to log date shipped, shipped via & FOB information
Convenient snapset format
10 description lines
Custom Cash Receipt Book, 4-to-a-page, Triplicate, 200 Sets/Book
Item #: 901-TCRB1143
4-Up
Triplicate
200 sets per book
Wilson Jones Minute Record Book, 9.3"W x 11.6"H, Black, 250 Sheets/Book (W0395-11)
Item #: 901-2660936
Black handbound imitation leather cover with gold-tooled spines
Includes 250 letter-size sheets: 8.5"W x 11"L
Overall dimensions: 9.3"W x 11.6"H x 1.7"D
$452.99
Per each
Boorum & Pease 38 Series Record Book, 7.63" x 9.63", Black/Red, 150 Sheets/Book (38-300-R)
Item #: 901-38300R
Book for records and daily schedules
Elegant black covers with red spine and corners
Includes 300 numbered pages
$104.99
1-4 each
Save 14%
$89.99
5+ each
Custom Classic Design, Lined Small Format Invoices, 3 Parts, 1 Color Printing, 8 1/2" x 7", 250/Pack
Item #: 901-D1083
Get the details: Includes 13 description lines on this lined form to record the invoice details
Consecutively numbered for easy recordkeeping
Promote your business: Personalization includes your imprint plus choice of typeface and standard logo
Rediform 3-Part Carbonless Purchase Order, 8 1/2" x 11", 50 Sets/Book (1L147)
Item #: 901-65084
Purchase order forms come in a manifold book and are carbonless with blue print
Consecutively numbered in red
Three-Part forms
$46.99
1-2 each
Save 19%
$37.99
3+ each
Custom 1-Sided Pegboard Account Cards, 5-1/2" x 8-1/2", 26# Coated Back Ledger Sheet, 500 Cards per Pack
Item #: 901-QFN101XX1R
For use with a pegboard system
5-1/2" W x 8-1/2" L
Comes in white colored 26# coated back ledger stock, printed in black ink
National Canvas Tuff Series Accounting Journal, 12.13" x 7.63", Green, 250 Sheets/Book (A66500J)
Item #: 901-A66500J
Green canvas cover
Sewn binding allows book to open flat for writing
Numbered pages
$75.99
Per each
Quill Brand® 9.5" x 11" Continuous Form Paper, 20 lbs., 92 Brightness 2550 Sheets/Carton (710657)
Item #: 901-710657
Continuous form bond paper
Paper weight: 20 lbs.
Size: 9-1/2x11" (8-1/2" width with carrier strips removed)
$122.39
Per carton
Staples Record Book, 7.25"W x 11.75"H, Blue Marble, 300 Sheets/Book (886673)
Item #: 901-886673STP
Blue marble hardcover with silver foil stamped title
Includes 300 numbered pages, features blue and red lines
Overall dimensions: 7.25"W x 11.75"H
$53.99
Per each
Medical Arts Press® Single Copy Rx Blanks; Vertical, Alter-Proof
Item #: 901-16034
Tamper-resistant Rx pad features 5 security features; meets October 1st 2008 Medicaid Requirements
Alter-proof blue pattern background to ensure there are no erasures or modifications of information
Void Pantograph — the word "void" will appear when photocopied
Cash Receipts Journal, 10 Column Journal, 10" x 8 1/2", 1 book
Item #: 901-QD126051N
Sprial bound book with 47 pages
10 blank headings
Room for 987 entries
$73.99
Per each
Boorum & Pease 66 Series Record Book, 7.63"W x 12.13"L, Blue, 150 Sheets/Book (ESS-66-300-R)
Item #: 901-708966
Blue canvas cover with record title
Includes 300 numbered pages
Overall dimensions: 7.63"W x 12.13"H
$103.99
Per each
Quill Brand® 14-7/8 "x 11" Continuous Form 1/2" Blue Bar Paper, 20 lbs., 2700 Sheets/Carton (QU710604)
Item #: 901-710604
1/2" blue bar Bond paper for continuous form printing
Paper weight: 20 lbs.
Size 14-7/8x11"
$196.39
Per carton
($0.07/EACH)
ComplyRight 2 Part Small Request for Time Off, Pack of 50 (A2203)
Item #: 901-2549338
Attorney-approved to ensure 100% compliance
Pack of 50 forms
Clearly outlines who is requesting and who approves paid time off
$91.99
1-3 each
Save 7%
$85.99
4+ each
Rediform Emerald Series Record Book, 7.25"W x 12.25"H, Green, 150 Sheets/Book (56131)
Item #: 901-854080
Green canvas hardcover and silk screened title
Includes 300 numbered pages with blue ruling and margin
Overall dimensions: 7.25"W x 12.25"H
$50.99
Per each
ComplyRight 1-Part Personnel Folder, 25/Pack (A222)
Item #: 901-1949183
Expandable confidential personnel folder protects legally sensitive information
One-part personnel folder
Contains 25 files per package
$142.99
1-2 each
Save 18%
$116.99
3+ each
Boorum & Pease Record Book, 7 5/8" x 12 1/2", Green, 150 Sheets/Book (67 1/8-300-R)
Item #: 901-6718300R
Timeless book features acid-free paper, permanent, waterproof ink, smyth-sewn binding, numbered pages and a Table of Contents page.
Brand: Boorum & Pease
Manufacturer: Esselte Pendaflex Corp.
$89.99
1-2 each
Save 8%
$82.99
3+ each
Custom Disability Certification Slips, 8-1/2" x 5-1/2", 100 Sheets per Pad
Item #: 901-QFN132131R
For certification of care
8-1/2" W x 5-1/2" L
White 20# text stock; printed in black ink
Custom Snap Apart Sales Slips, 3 part, 8-1/2" x 5-2/3", 500 Sheets
Item #: 901-TGSCC6523
3-part carbonless
Sales slip measures 8-1/2"Hx5-2/3"W
500 loose sheets
Boorum & Pease 66 Series Record Book, 7.63"W x 12.13"H x 1"D, Blue, 250 Sheets/Book (66-500-J)
Item #: 901-66500J
Art deco-styled blue canvas cover with record title
Includes 500 numbered pages
Overall dimensions: 7.63"W x 12.13"H x 1"D
$100.99
Per each
ComplyRight 2025-2026 Academic Year Attendance Calendar Cards, 50/Pack (A43005015)
Item #: 901-1949178TFP
Features an academic year calendar format (August 1 – July 31) and easy coding system
Efficient calendar format makes tracking absences quick and convenient
Reverse side includes plenty of space to record notes and warnings
$71.43
Per pack
