ADA CodeProcedure DescriptionMember Pays*
Preventive & Diagnostic
D0120 Periodic Exam NO CHARGE
D0140 Limited Exam - Problem Focused NO CHARGE
D0150 Comprehensive Exam NO CHARGE
D0210 Full Mouth X-Rays NO CHARGE
D0330 Panoramic X-Rays NO CHARGE
D1110 Adult Cleaning 15-30% OFF
Restorative
D2330 Filling - 1 Surface, Anterior 15-30% Off
D2391 Filling - 1 Surface, Posterior 15-30% Off
D2740 Crown - Porcelain/Ceramic 15-30% Off
D2950 Core Buildup - Including Pins 15-30% Off
Endodontics & Periodontics
D3310 Root Canal - Anterior 15-30% Off
D3320 Root Canal - Bicuspid 15-30% Off
D3330 Root Canal - Molar 15-30% Off
D4341 Perio Scaling/Root Planing - 4+ Teeth 15-30% Off
D4910 Periodontal Maintenance 15-30% Off
Prosthodontics & Oral Surgery
D5110 Complete Denture (Upper or Lower) 15-30% Off
D5213 Partial Denture (Upper or Lower) 15-30% Off
D7140 Simple Extraction 15-30% Off
D7210 Surgical Extraction 15-30% Off

*Member savings may vary by location. Free exams and x-rays limited to 2x per member/per annual membership term. Please speak to your Dentacare office prior to treatment.