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| Description | CDT Code | Qty/Yr | Value |
| Emergency Exam | D0140 | 2 | $210 |
| Regular Exams | D0120 | 1 | $70 |
| Comprehensive Exam | D0150 | 1 | $125 |
| Periodontal Maintenance | D4910 | 1 | $190 |
| Full Mouth Debridement | D4355 | 1 | $240 |
| Routine X-Rays | Varies | As Needed | $490 |
| Total | $1325 |
The following highlights the discounts provided for each dental procedure category as part of this membership plan:
Procedure Category |
Discount |
| Diagnostic | 20% |
| Preventive | 20% |
| Restorative | 20% |
| Endodontics | 20% |
| Periodontics | 20% |
| Prosthodontics Removable | 20% |
| Maxillofacial Prosthetics | 20% |
| Implant Services | 20% |
| Prosthodontics Fixed | 20% |
| Oral And Maxillofacial Surgery | 20% |
| Adjunctive General Services | 20% |
| Description | CDT Code | Qty/Yr | Value |
| Emergency Exam | D0140 | 1 | $105 |
| Regular Exams | D0120 | 1 | $70 |
| Comprehensive Exam | D0150 | 1 | $125 |
| Professional Cleanings | D1120 | 2 | $180 |
| Fluoride Varnish | D1206 | 2 | $100 |
| Routine X-Ray | Varies | As Needed | $490 |
| Total | $1070 |
The following highlights the discounts provided for each dental procedure category as part of this membership plan:
| Procedure Category | Discount |
| Diagnostic | 20% |
| Preventive | 20% |
| Restorative | 20% |
| Endodontics | 20% |
| Periodontics | 20% |
| Prosthodontics Removable | 20% |
| Maxillofacial Prosthetics | 20% |
| Implant Services | 20% |
| Prosthodontics Fixed | 20% |
| Oral And Maxillofacial Surgery | 20% |
| Adjunctive General Services | 20% |
| Description | CDT Code | Qty/Yr | Value |
| Emergency Exam | D0140 | 2 | $210 |
| Regular Exams | D0120 | 1 | $70 |
| Comprehensive Exam | D0150 | 1 | $125 |
| Professional Cleanings | D1110 | 2 | $250 |
| Routine X-Rays | Varies | As Needed | $490 |
| Total | $1145 |
The following highlights the discounts provided for each dental procedure category as part of
this membership plan:
| Procedure Category | Discount |
| Diagnostic | 20% |
| Preventive | 20% |
| Restorative | 20% |
| Endodontics | 20% |
| Periodontics | 20% |
| Prosthodontics Removable | 20% |
| Maxillofacial Prosthetics | 20% |
| Implant Services | 20% |
| Prosthodontics Fixed | 20% |
| Oral And Maxillofacial Surgery | 20% |
| Adjunctive General Services | 20% |