Amazing Charts
APPROVED FORMAT
MEDICAL SCRIPTS

Manufactured by Micro Format, Inc.
www.RxPaper.com/amazingcharts

Rx503 FULL SHEET
Tamper Resistant Prescription Paper

Print prescriptions with your Laser or Ink Jet Printer.


All Micro Format Tamper Resistant Rx Paper Products
meet and exceed ALL Medicaid Requirements.

View Features as they relate to the Medicaid Requirements

  • Not approved for use in the States of New Jersey, New York, Indiana, Kentucky.
  • This format is approved for use in the State of Florida
  • This format may be used in the State of California ONLY for prescribing Non-Controlled Substance medications
    Meets ALL Medicaid Requirements.
    View Security Features and how they relate to the Medicaid Requirements.
    • Item# Rx503
      Blue Background

      Laser Prescription Rx503

    Blue Background Secure Tamper Resistant
    Laser Prescription Paper

    Blue Background
    Rx503

    500 sheets per package
    $ 60.00 plus shipping by UPS


    1000 sheets per package
    $ 80.00 plus shipping by UPS


    1 carton (2,500 sheets per carton)
    $187.50 plus shipping by UPS


    2 cartons (2,500 sheets per carton)
    $175.00 per carton plus shipping by UPS


    • Item# Rx503G
      Green Background

    Green Background Secure Tamper Resistant
    Laser Prescription Paper

    Green Background Rx503G

    500 sheets per package
    $ 60.00 plus shipping by UPS


    1000 sheets per package
    $ 80.00 plus shipping by UPS


    1 carton (2,500 sheets per carton)
    $187.50 plus shipping by UPS


    2 cartons (2,500 sheets per carton)
    $175.00 per carton plus shipping by UPS



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    All Rights Reserved 
    Micro Format, Inc. 
    830-3 Seton Court ~ Wheeling, IL 60090 
    847/520-4699 FAX 847/520-0197
    Toll Free: 800-333-0549