(2) CMS-1450 (UB-04).(3) American Dental Association (ADA) claim form.As added by P.L.162-2001, SEC.5. Amended by P.L.208-2018, SEC.10.
Indiana Legal Code
(2) CMS-1450 (UB-04).(3) American Dental Association (ADA) claim form.As added by P.L.162-2001, SEC.5. Amended by P.L.208-2018, SEC.10.