Dental Claim Form (2012 Version), 100 Forms per Pad - J430
- Product Code:
-
J430
- Member Price:
-
$15.00
- Retail Price:
-
$22.50
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.
Volume Discount: Order 5+ packs, save
20%!
