Periodic oral exam
About this procedure
Procedure code: D0120Procedure description: Regular dental exam to determine any changes in your oral health since your last exam.Coverage & costs for this procedure
Quin Parker’s plan covers 100% of this procedure
Coverage can vary depending on the dentist you go to and the network that dentist is in. For the most savings, go to a dentist in the Delta Dental PPO network.
Getting ready to visit the dentist?
Plan ahead for a visit
You can visit any dentist in any network. Your coverage and costs will vary by dentist and the dentist's network.Pre-authorization from Delta Dental is <not required> to receive coverage for this procedure. Your dental provider will file a request to Delta Dental on your behalf.Provider's networkAge limits & plan coverageOut-of-pocket
cost estimate
cost estimate
NON-Delta Dental
coming soon
No age limit
Cost estimate 80%
Does not apply to maximums
Does not apply to maximums
coming soon
Delta Dental Premier
coming soon
No age limit
Cost estimate 80%
Does not apply to maximums
Does not apply to maximums
coming soon
Delta Dental PPO
coming soon
No age limit
Cost estimate 80%
Does not apply to maximums
Does not apply to maximums
coming soon
Limitations for this procedure
General limitsAge limitsEligible teeth
Benefit is limited to one occlusal guard within a 5 year period.
Plan members over the age of 12 are eligible for this procedure.
01, 02, 03, 04, 05, 06, 07, 08, 09, 10, 11, 12, T, S, C, D, A, F, R, T
This information is based on our records and claims processed as of the day you accessed this system. This is not an authorization, nor a guarantee of eligibility, benefits, or payment.