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ComplyRight 1-Part Dental Claims, 2500/Pack (19011)

See pricing info, deals and product reviews for ComplyRight 1-Part Dental Claims, 2500/Pack (19011) at Quill.com. Order online today and get fast, free shipping for your business.
Item #: 901-24433065
  Model #: 1901
Brand: ComplyRight
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ComplyRight 1-Part Dental Claims, 2500/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 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
Number of Parts : 1 True Color : Black/White Width in Inches : 9 Length in Inches : 11
HR Form Pack Size : 2500 HR Form Type : Dental Claims (40430) Pack Qty : 2500 Brand : ComplyRight
Customizable : No
Weight : 10.00 lbs. per Each
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