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Get Dental Claim Form - AHP

Caid The instructions describe information that is required to be entered in each of the block numbers on the ADA Dental Claim Form 2006 for submission to EDS. The claim should be typewritten or computergenerated whenever possible. For program specific billing information, please refer to the Alabama Medicaid Provider Manual, Chapter 13, Dental, available on the Agency s website at: http://www.medicaid.alabama.gov/billing/provider manuals 2008.aspx?tab 6 ADA Block Number 3 ADA Description Ala.

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