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Original price was: $15.59.$10.13Current price is: $10.13.
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This ADA dental claim form allows healthcare providers to bill a patient’s insurance company for reimbursement of dental claims. These forms in laser format feature 8.5″ x 11″ size. This is the latest version of the claim/attending dentist form (2019).
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Dental claim forms
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100 forms per pack
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Comes as a white sheet with black text
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Dimensions: 8.5″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
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Features laser format
| Brand | ComplyRight |
|---|---|
| Customizable | No |
| HR Form Pack Size | 100 |
| HR Form Type | Dental Claims |
| Length in Inches | 11 |
| Pack Qty | 100 |
| True Color | Black/White |
| Width in Inches | 8.5 |
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