ComplyRight Dental Claim, 500/Pack (1900500)
Item #:
901-24433064
Model #:
1900500
Brand:
ComplyRight
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Item #: 901-24433064
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Total
$110.97
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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. This form in laser format features 8.5" x 11" size. This is the latest version of the claim/attending dentist form (2019).
- Dental claim form
- 500 forms per pack
- Comes as a white sheet with black text
- Dimensions: 8.5"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
- Features laser format
Specifications
Brand
ComplyRight
Form Size
8 1/2" x 11"
Length in Inches
11
Medical Form Pack Size
500
Medical Form Type
Dental Claims
Pack Qty
500
Print Type
Laser
True Color
Black/White
Width in Inches
8.5