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In this video tutorial, the presenter demonstrates how to fill out the upper section of a dental insurance claim form for Hugh Morus. The first step is to select "statement of actual services" in the header information box. The authorization number in box two should be marked as N/A (not applicable). In box three, the insurance company details are entered, specifically Prudential insurance, including its address (P.O. Box 807, New York, NY 00216). Boxes four through eleven pertain to other insurance coverage, specifically for cases of dual coverage, which would need to be filled if applicable.