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2000 and 1994 ADA-Approved Claim Forms - Patterson Office Supplies
2000 and 1994 ADA-Approved Claim Forms
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2000 and 1994 ADA-Approved Claim Forms
1994 personalized forms allow for office/doctors information to be added in boxes 21-26. 2000 personalized forms allow for office/doctors information to be added in boxes 42-47 and 50-52.
If in doubt about the correct ID number to use, please consult your carrier for information. You must provide us with the correct information.
ADA Dental Claim Form is reproduced and distributed by Patterson Office Supplies under license from the American Dental
Title/Description
Patterson Item #
Mfg Item #
Price
Qty
1994 ADA-Approved Claim Forms, 2-Part Continuous, Nonpersonalized, 8-1/2" W x 11" H, 1000/pkg
1994 ADA-Approved Claim Forms, 2-Part Continuous, Nonpersonalized, 8-1/2" W x 11" H, 1000/pkg
Patterson Office Supplies
1994
050-8317
18001
See My Price
2000
051-7391
18115
See My Price
1994 ADA-Approved Claim Forms, Laser Compatible Sheet, Nonpersonalized, 8-1/2" W x 11" H, 500/pkg
1994 ADA-Approved Claim Forms, Laser Compatible Sheet, Nonpersonalized, 8-1/2" W x 11" H, 500/pkg
Patterson Office Supplies
1994
057-6454
21122
See My Price
2000 and 1994 ADA-Approved Claim Forms, 1-Part Continuous, Nonpersonalized, 8-1/2" W x 11" H, 1000/pkg
2000 and 1994 ADA-Approved Claim Forms, 1-Part Continuous, Nonpersonalized, 8-1/2" W x 11" H, 1000/pkg
Patterson Office Supplies
1994
050-9349
18000
See My Price
2000
051-7367
18114
See My Price
2000 and 1994 ADA-Approved Claim Forms, 2-Part Carbonless Sets, Nonpersonalized, 8-1/2" W x 11" H, 500/pkg
2000 and 1994 ADA-Approved Claim Forms, 2-Part Carbonless Sets, Nonpersonalized, 8-1/2" W x 11" H, 500/pkg
Patterson Office Supplies
1994
050-8283
18010
See My Price
2000
051-7342
18123
See My Price
2000 and 1994 ADA-Approved Claim Forms, 2-Part Carbonless Sets, Personalized, 8-1/2" W x 11" H, 500/pkg
2000 and 1994 ADA-Approved Claim Forms, 2-Part Carbonless Sets, Personalized, 8-1/2" W x 11" H, 500/pkg
Patterson Office Supplies
1994
050-9778
18009
See My Price
2000
077-0487
18122
See My Price
2000 and 1994 ADA-Approved Claim Forms, Laser Compatible Sheet, Nonpersonalized, 8-1/2" W x 11" H, 500/pkg
2000 and 1994 ADA-Approved Claim Forms, Laser Compatible Sheet, Nonpersonalized, 8-1/2" W x 11" H, 500/pkg
Patterson Office Supplies
1994
050-9364
18003
See My Price
2000
051-7383
18117
See My Price
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Bond, Padded, Personalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Bond, Padded, Personalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
Patterson Office Supplies
1994
077-0529
18006
See My Price
2000
077-0461
18120
See My Price
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Bond, Padded, Personalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Bond, Padded, Personalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
Patterson Office Supplies
1994
050-8226
18007
See My Price
2000
051-5692
18121
See My Price
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Carbonless, Nonpersonalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Carbonless, Nonpersonalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
Patterson Office Supplies
1994 personalized forms allow for office/doctors information to be added in boxes 21-26. 2000 personalized forms allow for office/doctors information to be added in boxes 42-47 and 50-52.
If in doubt about the correct ID number to use, please consult your carrier for information. You must provide us with the correct information.
ADA Dental Claim Form is reproduced and distributed by Patterson Office Supplies under license from the American Dental
1994
050-8259
18005
See My Price
2000
051-5890
18119
See My Price
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Carbonless, Personalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
2000 and 1994 ADA-Approved Claim Forms, Single-Sheet Carbonless, Personalized, 8-1/2" W x 11" H, 100 Sheets/Pad; 5 Pads/Pkg
Patterson Office Supplies
1994
077-0503
18004
See My Price
2000
077-0446
18118
See My Price
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