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ComplyRight Dental Claim, 1000/Pack (19001)
$78.89
1

ComplyRight Dental Claim, 1000/Pack (19001)

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Item #: 24433071 Model #: 19001
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  • Dental claim form
  • 1000 forms per pack
  • Comes as a white sheet with black text
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$78.89
$78.89
$78.89
$47.34
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About this product

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
  • 1000 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