ComplyRight ADA Dental Claim Form, 1-Part Continuous, 1000/Pack

Item: 728273 Model: 26011

All claim forms officially licensed by the American Dental Association and supported by most popular dental software packages
100% compliant to meet ADA guidelines
Accommodates reporting of National Provider Identifier (NPI)

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Product Details

Authorized for use by the American Dental Association, these dental claim forms allow the attending dentist to bill patients’ insurance providers for reimbursement of dental claims.

All claim forms officially licensed by the American Dental Association and supported by most popular dental software packages
100% compliant to meet ADA guidelines
Accommodates reporting of National Provider Identifier (NPI)
Printed with special "dropout" red ink on 20# paper
Designed for processing on high speed OCR scanning equipment
Continuous formats
Version 2006
Dimensions: 8-1/2" W x 11" H
Pack size 1000