Dental Claim Form, packs of 250 - ADA J432
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Dental Claim Form (2012 Version), Packs of 250 - J432

Dental Claim Form (2012 Version), Packs of 250 - J432
Product Code:
J432
Member Price:
$20.00
Retail Price:
$30.00
Available:
Yes
Quantity


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. 8-1/2 x 11 bond stock. 250 individual forms per pack.