Richard A. Workman, DMD
115 Indian Rock Road Windham, NH 03087
Dental Procedures
| Procedure | Estimate of Total Cost | Number of Visits | What You Will Pay Uninsured Discount: 0% |
|---|---|---|---|
| Dental Cleaning - Adult | $111 | N/A | $111 |
| Dental Cleaning - Child | $95 | N/A | $95 |
| Dental Exam - Comprehensive | $210 | N/A | $210 |
| Dental Exam - Periodic, Established Patient | $56 | N/A | $56 |
| Dental Filling - Silver (Amalgam): One Surface, Primary or Permanent | $268 | N/A | $268 |
| Dental Filling - Silver (Amalgam): Three Surfaces, Primary or Permanent | $247 | N/A | $247 |
| Dental Filling - Silver (Amalgam): Two Surfaces, Primary or Permanent | $210 | N/A | $210 |
| Dental Filling - White (Resin): One Surface, Posterior | $412 | N/A | $412 |
| Dental Filling - White (Resin): Three Surfaces, Posterior | $399 | N/A | $399 |
| Flouride - Topical Varnish Application | $58 | N/A | $58 |
| Plaque and Tartar Removal - Around Teeth and Gums, Per Quadrant | $368 | N/A | $368 |
| Problem Focused Evaluation - Limited to a Specific Oral Health Problem or Complaint | $95 | N/A | $95 |
| X-Ray - Complete Intraoral Series | $168 | N/A | $168 |
| X-Ray - Four Images, Bitewings | $95 | N/A | $95 |
| X-Ray - Intraoral, Periapical Radiographic Image | $47 | N/A | $47 |