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ADA 2012 Insurance Claim Form, Laser Sheet

Item#: Size:
Quantity 500 1000 2000 5000 10000
60156X  Not Imprinted $58.99 $102.99 $176.99 $431.99 $861.99
We recommend this quantity.
1.  Quantity

Benefits and Features

Speed your third-party billing with updated claim/attending dentist forms. Authorized by the American Dental Association (ADA) and ready for your laser printer, these forms keep information neat for faster, more error-free processing.

  • Convenient and easy to use

    ADA compliant laser forms make third party billing a breeze
  • Expanded format

    accepts updated billing codes and has more room for provider and patient ID numbers
  • Fold lines on forms

    help ensure proper placement of address in envelope window
  • Use with envelope: