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. Sold as 1 Each.
Cheapest price in the interval: 11.57 on October 27, 2021
Most expensive price in the interval: 11.65 on November 8, 2021
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