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ADA Dental Claim Form (2019 Version)

$22.50

T12!

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The ADA Dental Claim Form is revised to incorporate a significant change in the HIPAA standard, which now enables a dentist to include a diagnosis code (ICD-9-CM) when needed on a claim.

Pad of 100 – 8-1/2 x 11 sheets.

Additional information

Weight 2 lbs

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