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ComplyRight 1-Part Dental Claim, 1000/Pack (19011)

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Item #: 901-24433060
  Model #: 19011
Brand: ComplyRight
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ComplyRight 1-Part Dental Claim, 1000/Pack (19011)
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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).
  • Dental claim form
  • Continuous format, single-part
  • 1000 forms per pack
  • Comes as a white sheet with black text
  • Dimensions: 9"W x 11"L
  • This is the latest version of the claim/attending dentist form (2019)
  • 100% compliant to meet the American Dental Association (ADA) guidelines
Specifications
Number of Parts : 1 True Color : Black/White Width in Inches : 9 Length in Inches : 11
HR Form Pack Size : 1000 HR Form Type : Dental Claims (40430) Pack Qty : 1000 Brand : ComplyRight
Customizable : No
Weight : 7.00 lbs. per Each

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