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