Diagnostic Treatment For $0.00 Co-Payment
- Periodic oral evaluation
- Limited oral evaluation - problem focused
- Oral Evaluation for a patient under three years of age and counseling with primary caregiver
- Comprehensive oral evaluation - new or established patient
- Detailed and extensive oral evaluation - problem focused, by report
- Re-evaluation - limited, problem focused (established patient; not post-operative visit)
- Comprehensive periodontal evaluation - new or established patient
Radiographs / Diagnostic Imaging For $0.00 Co-Payment
- Intraoral - complete series (including bitewings)
- Intraoral - periapical first film
- Intraoral - periapical each additional film
- Intraoral - occlusal film
- Extraoral - first film
- Extraoral - each additional film
- Bitewing - single film
- Bitewings - two films
- Bitewings- three films
- Bitewings - four films
- Vertical bitewings – 7 to 8 films
- Panoramic film
- Oral/facial photographic images
Tests and Examinations For $0.00 Co-Payment
- Collection of microorganisms for culture and sensitivity
- Caries susceptibility tests
- Pulp vitality tests
- Diagnostic castsAccession of tissue, gross examination, preparation and transmission of written report
- Accession of tissue, gross and microscopic examination, preparation and transmission of written report
- Accession of tissue, gross and microscopic examination, including assessment of surgical margins for presence of disease, preparation and transmission ofwritten report
- Laboratory accession of brush biopsy sample, microscopic examination, preparation and transmission of written report
Preventive Services For $0.00 Co-Payment
- Prophylaxis - adult
- Prophylaxis – child
- Topical application of fluoride (prophylaxis not included) - child
- Topical application of fluoride (prophylaxis not included) - adult
- Topical fluoride varnish; therapeutic application for moderate to high caries risk
patients - Nutritional counseling for control of dental disease
- Tobacco counseling for the control and prevention of oral disease
- Oral hygiene instructions
- Sealant - per tooth
Restorative Treatment For $0.00 Co-Payment
- Amalgam - one surface, primary or permanent
- Amalgam - two surfaces, primary or permanent
- Amalgam - three surfaces, primary or permanent
- Amalgam - four or more surfaces, primary or permanent
- Resin-based composite - one surface, anterior
- Resin-based composite - two surfaces, anterior
- Resin-based composite - three surfaces, anterior
- Resin-based composite - four or more surfaces or involving incisal angle (anterior)
Crowns Service For $0.00 Co-Payment
- Provisional crown
- Recement inlay, onlay, or partial coverage restoration
- Recement cast or prefabricated post and core
- Recement crown
- Sedative filling
- Temporary crown (fractured tooth)
- Crown repair, by report
Crowns/Fixed Bridges - Per Unit For $0.00 Co-Payment
- Provisional pontic
- Recement fixed partial denture
Adjunctive General Services For $0.00 Co-Payment
- Fixed partial denture sectioning
- Local anesthesia not in conjunction with operative or surgical procedures
- Regional block anesthesia
- Trigeminal division block anesthesia
- Local anesthesia
- Consultation (diagnostic service provided by dentist other than practitioner
providing treatment) - Office visit for observation (during regularly scheduled hours) -no other services
performed - Case presentation, detailed and extensive treatment planning
For More Information or To Sign Up For This Program Visit Fezdental.
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