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2 periodic oral evaluation - established patient
2 prophylaxis - adult
1 bitewings - four radiographic images
2 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 panoramic radiographic image
1 comprehensive oral evaluation - new Dr established patient
Adult
Ages 13-54
$27.00/Month $325.00/Year
2 periodic oral evaluation - established patient
2 prophylaxis - adult
1 bitewings - four radiographic images
2 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 panoramic radiographic image
1 comprehensive oral evaluation - new Dr established patient
$27.00/Month $325.00/Year
2 periodic oral evaluation - established patient
2 prophylaxis - adult
1 bitewings - four radiographic images
2 topical application of fluoride varnish
1 limited oral evaluation - problem focused
2 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 intraoral - comprehensive series of radiographic images
1 panoramic radiographic image
Ages +55
$25.00/Month $300.00/Year
Senior
$25.00/Month $300.00/Year
2 periodic oral evaluation - established patient
2 prophylaxis - adult
1 bitewings - four radiographic images
2 topical application of fluoride varnish
1 limited oral evaluation - problem focused
2 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 intraoral - comprehensive series of radiographic images
1 panoramic radiographic image
2 periodic oral evaluation - established patient
2 prophylaxis- child
1 bitewings - two radiographic images
2 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 panoramic radiographic image
1 intraoral - comprehensive series of radiographic images
Child
Ages 1-12
$15.00/Month $175.00/Year
2 periodic oral evaluation - established patient
2 prophylaxis- child
1 bitewings - two radiographic images
2 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 panoramic radiographic image
1 intraoral - comprehensive series of radiographic images
$15.00/Month $175.00/Year
2 periodic oral evaluation - established patient
3 periodontal maintenance
1 bitewings - four radiographic images
3 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 intraoral - comprehensive series of radiographic images
1 panoramic radiographic image
Periodontal
Ages 13+
$42.00/Month $500.00/Year
$42.00/Month $500.00/Year
2 periodic oral evaluation - established patient
3 periodontal maintenance
1 bitewings - four radiographic images
3 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 intraoral - comprehensive series of radiographic images
1 panoramic radiographic image
2 periodic oral evaluation - established patient
3 periodontal maintenance
1 bitewings - four radiographic images
3 topical application of fluoride varnish
1 limited oral evaluation - problem focused
1 intraoral - periapical first radiographic image
1 comprehensive oral evaluation - new Dr established patient
1 intraoral - comprehensive series of radiographic images
1 panoramic radiographic image