ComplyRight 1-Part Dental Claim, 1000/Pack (19011)
$31.99
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Description
This ADA dental claim form allows healthcare providers to bill a patient’s insurance company for reimbursement of dental claims. Single-part form in continuous format features 9″ x 11″ size. This is the latest version of the claim/attending dentist form (2019).
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Dental claim form
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Continuous format, single-part
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1000 forms per pack
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Comes as a white sheet with black text
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Dimensions: 9″W x 11″L
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This is the latest version of the claim/attending dentist form (2019)
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100% compliant to meet the American Dental Association (ADA) guidelines
| Brand : ComplyRight | Customizable : No | HR Form Pack Size : 1000 | HR Form Type : Dental Claims |
| Length in Inches : 11 | Number of Parts : 1 | Pack Qty : 1000 | True Color : Black/White |
| Width in Inches : 9 | |||
| Weight : 7.00 lbs. per Each |
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