Yes! Here is the **full list of ~70 input fields** needed for **837D (Dental Claims)**.  

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### **📌 837D (Dental) Input Fields (Grouped by Section)**  

#### **🔹 Part 1: Transaction & File Control (Same as 837P/I)**
1. **Sender ID**  
2. **Receiver ID**  
3. **Transmission Date**  
4. **Transmission Time**  
5. **Control Number**  
6. **Sender Code**  
7. **Receiver Code**  
8. **GS Date**  
9. **GS Time**  
10. **GS Control Number**  

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#### **🔹 Part 2: Submitter & Receiver Details**
11. **Submitter Name**  
12. **Submitter ID**  
13. **Receiver Name**  
14. **Receiver ID**  

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#### **🔹 Part 3: Billing & Facility Information**
15. **Billing Provider Name**  
16. **Billing Provider NPI**  
17. **Billing Provider Tax ID**  
18. **Billing Provider Street**  
19. **Billing Provider City**  
20. **Billing Provider State**  
21. **Billing Provider ZIP**  
22. **Facility Name**  
23. **Facility NPI**  
24. **Facility Street**  
25. **Facility City**  
26. **Facility State**  
27. **Facility ZIP**  

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#### **🔹 Part 4: Patient & Subscriber Information**
28. **Patient Last Name**  
29. **Patient First Name**  
30. **Patient DOB (YYYYMMDD)**  
31. **Patient Gender (M/F/U)**  
32. **Patient Member ID**  
33. **Patient Street**  
34. **Patient City**  
35. **Patient State**  
36. **Patient ZIP**  

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#### **🔹 Part 5: Claim Information**
37. **Claim Number**  
38. **Total Claim Amount**  
39. **Facility Type Code**  
40. **Claim Frequency Code**  
41. **Primary Diagnosis Code (ICD-10-CM Format)**  
42. **Additional Diagnosis Codes**  
43. **Place of Service**  

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#### **🔹 Part 6: Dental-Specific Fields (NEW in 837D)**
44. **Tooth Number** (e.g., 1-32 for permanent teeth, A-T for primary teeth)  
45. **Tooth Surface** (M=Mesial, D=Distal, O=Occlusal, I=Incisal, L=Lingual, etc.)  
46. **Oral Cavity Location** (e.g., Quadrant 1-4, Arch U/L)  
47. **Missing Teeth Information** (Indicator for missing teeth)  
48. **Replacement Status** (Yes/No for dentures, bridges, implants)  
49. **Procedure Date** (YYYYMMDD)  
50. **Prosthesis Initial or Replacement Code**  
51. **Orthodontic Treatment Indicator** (Yes/No)  
52. **Orthodontic Treatment Start Date**  
53. **Orthodontic Treatment End Date**  
54. **Anesthesia Usage Indicator** (Yes/No)  
55. **Anesthesia Type** (Local/General)  
56. **Emergency Treatment Indicator** (Yes/No)  

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#### **🔹 Part 7: Service Line Details**
57. **Procedure Code (CDT - Current Dental Terminology)**  
58. **Revenue Code**  
59. **Charge Amount**  
60. **Units of Service**  
61. **Service Date (YYYYMMDD)**  
62. **Condition Codes (If applicable)**  

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#### **🔹 Part 8: Payer Information**
63. **Payer Name**  
64. **Payer ID**  
65. **Payer Street**  
66. **Payer City**  
67. **Payer ZIP**  

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#### **🔹 Part 9: Provider Information**
68. **Attending Provider Name**  
69. **Attending Provider NPI**  

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#### **🔹 Part 10: EDI Control Segments**
70. **SE01 (Number of Included Segments)**  
71. **SE02 (Transaction Set Control Number)**  
72. **GE Control Number**  
73. **IEA Control Number**  

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### **✅ Summary**
- **Total Fields: ~73 (including Dental-Specific Fields)**
- **New Fields (Compared to 837P & 837I):**  
  🦷 **Tooth Number, Surface, Oral Cavity, Missing Teeth, Anesthesia, Orthodontics, Prosthesis, etc.**  

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### **🚀 Next Steps**
Would you like me to:
1. **Break these down into form parts (like we did for 837P & 837I)?**  
2. **Start with Laravel validation rules for these fields?**  
3. **Begin the EDI file generation for 837D?**  

Let me know how you want to proceed! 😊