ComplyRight 1-Part Dental Claims, 2500/Pack (19011)
Item #:
901-24433065
Model #:
1901
Brand:
ComplyRight
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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 forms in continuous format feature 9" x 11" size. This is the latest version of the claim/attending dentist form (2019).
- Dental claim forms
- Continuous format, single-part
- 2500 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
Brand
ComplyRight
HR Form Pack Size
2500
HR Form Type
Dental Claims
Length in Inches
11
Number of Parts
1
Pack Qty
2500
True Color
Black/White
Width in Inches
9