ComplyRight ADA Dental Claim Form, Laser-Cut Sheet, 1000/Cartoon

Item: 728276 Model: 12001

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)
Designed for processing on high speed OCR scanning equipment
Laser Cut Sheet
Printed with special "dropout" red ink on 20# paper
Version 2006
Dimensions: 8-1/2" W x 11" H
1000 per carton