Amazing Charts
APPROVED FORMAT
MEDICAL SCRIPTS
Manufactured by Micro Format, Inc.
www.RxPaper.com/amazingcharts
TAMPER RESISTANT
Stock Format Laser Prescription Paper for use in the
State of Indiana


8-1/2" x 11" Format:

  • Script in top left-hand corner

    5-1/2" x 8-1/2" Format:

  • 2 scripts per sheet ~ over/under

    • 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
    500 sheets per package
    $ 70.00 plus shipping by UPS    		 Click to ADD to your Shopping Cart
    Rx510-IN-1000
    1000 sheets per package
    $ 90.00 plus shipping by UPS
    		 Click to ADD to your Shopping Cart
    Rx510-IN-2500
    1 carton (2,500 sheets per carton)
    $212.50 plus shipping by UPS
    		 Click to ADD to your Shopping Cart
    Rx510-IN-5000
    2 cartons (2,500 sheets per carton)
    $200.00 per carton plus shipping by UPS
    		 Click to ADD to your Shopping Cart

    Sheet Size 5-1/2" x 8-1/2" ~~ 2 scripts per sheet
    Perforated 4-1/4" from top edge


    Item#RxEC503-IN
    Indiana Format
    Prescription Paper
    5-1/2" x 8-1/2"    		 500 sheets
    $55.00
    plus shipping by UPS

    To Order

    		1,000 sheets
    $75.00
    plus shipping by UPS

    To Order

    		2,500 sheets
    $175.50
    plus shipping by UPS

    To Order

    		5,000 sheets
    $345.00
    plus shipping by UPS

    To Order

    E-Mail: Questions send us an e-mail ~ Support@RxPaper.com
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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