ADA CodeProcedure DescriptionMember Pays*
DIAGNOSTIC & PREVENTATIVE
D0120 2 Periodic Exams per year FREE
D0210 2 Full Mouth X-Rays per year FREE
D1110 Adult Cleaning 20% Off
D4341 Perio Scaling/Root Planing - 4+ teeth 25% Off
D4910 Periodontal Maintenance 25% Off
D1208 Topical Application of Fluoride 20% Off
RESTORATIVE
D2330 Composite Filling - One Surface, Anterior 25% Off
D2331 Composite Filling - Two Surface, Anterior 25% Off
D2740 Crown - Porcelain/Ceramic 25% Off
D2750 Crown - Porcelain/High Noble Metal 25% Off
D2950 Core Buildup 25% Off
SPECIALTY
Endodontics 20% Off
Periodontics 20% Off
Orthodontics - includes Free Electric Toothbrush and Free Whitening Kit 10% Off
Nitrous Oxide 10% Off

*Free Exams and X-Rays are limited to 2 per annual membership term. Certain procedures may not be within the scope of practice or the ability of the general dentist.