Dental Claim Form, downloadable PDF - ADA J430D
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Dental Claim Form (2012 Version) Downloadable PDF - J430D

Dental Claim Form (2012 Version) Downloadable PDF - J430D
Product Code:
J430D
Member Price:
$29.95
Retail Price:
$44.95
Available:
Yes
Quantity


Downloadable version of the ADA Dental Claim Form allows immediate access and requires no shipping. 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.