APPROVED FORMAT
MEDICAL SCRIPTS

Manufactured by Micro Format, Inc.

www.rxpaper.com/EPOWERdoc/EPOWERdoc

TAMPER RESISTANT
Stock Format Laser Prescription Paper for use in the
State of Indiana




The following is an excerpt from the August 2007 letter sent to all State Medicaid Directors;

"Several States have laws and regulations concerning mandatory, tamper-resistant prescription pad programs, which were in effect prior to the passage of section 7002(b). CMS deems that the tamper-resistant prescription pad characteristics required by these States' laws and regulations meet or exceed the baseline standard, as set forth above."


Laser Prescription Paper ~ Rx510-IN

  • Sheet size: 8-1/2" x 11"
  • Full Horizontal Perforation 4-1/4" from top edge
  • Full Vertical Perforation 5-1/2" from left edge
  • ONE PRESCRIPTION per sheet
  • Blue Security Background
  • Contains all features required by Indiana State legislation. RX510-IN
    500 sheets per package
    $ 70.00 plus shipping by UPS


    1000 sheets per package
    $ 90.00 plus shipping by UPS


    1 carton (2,500 sheets per carton)
    $212.50 plus shipping by UPS


    2 cartons (2,500 sheets per carton)
    $200.00 per carton plus shipping by UPS



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Micro Format, Inc.
830-3 Seton Court ~ Wheeling, IL 60090
Phone: 847/520-4699 ~ 800-333-0549
Fax 847/520-0197