Medicaid Prescription Pads, Medicaid Rx Pads, Medicaid Tamper Resistant Prescriptions, CMS-1500 Forms, HCFA 1500 Forms, HCFAs, CMS-1500 Forms, Clinical Forms, Rx Pads, Prescription Pads, Medical Forms, Dental Forms, Medical Office Supplies, HCFA Envelopes, HIPAA Forms, Patient Charts, Medical Office Filing Supplies,

 
 
5 1/2" x 4 1/4" (100 Sheets Per Pad) (10 Pad Minimum)

2 Part WV Mandated Secure Rx Pads


Must be used for all prescriptions in West Virginia. Printed in Black ink on Pantone Green paper, with void panto on face, standard format per state guidelines, security backprint on back in opaque ink "West Virginia Security Prescription" as required by State of West Virginia. 2 part style has no printing, on CF Canary paper. To process West Virginia Mandated Prescription Pads, we must receive a copy of the DEA license and the West Virginia Medical or Dental License by fax at (800) 256-1433 once you have placed the order online.
Price: $11.00
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 Other Items from State of W. Virginia Approved Rx Pads

  2 Part WV Mandated Secure Rx Pads - 5 1/2" x 4 1/4" (100 Sheets Per Pad) (10 Pad Minimum)
  2 Part WV Mandated Secure Rx Pads - 5 1/2" x 4 1/4" (100 Sheets Per Pad) (10 Pad Minimum)

 
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