ComplyRight ADA Dental Claim Form, 1-Part Continuous, 2500 Box

Item: 728369 Model: 2601

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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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)
Designed for processing on high speed OCR scanning equipment
1-part continuous form
Printed with special "dropout" red ink on 20# paper
Version 2006
Dimensions: 8-1/2" W x 11" H
2500 per pack