Est 70864 From F K Dental Laboratory 3232

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F K Dental Laboratory Estimate

23 Zinyo House
Service Date: 25/03/2024
Wellington Park
Wellington Road VAT Reg. No: 4880188406
Durbanville,7550
Practice No: 0024619
Tel: (021) 979 3456/55/53 Whatsap: 072 0865936

admin@fkdental.co.za Lab reg no: LA824

Estimate To: Custom made device for:


DR HARTSHORNE Estimate No: 70864
43 OLD OAK ROAD
TYGERVALLEY Lab slip No:
7536
Member : SPENS, MR J

Medical Aid:
Practice No: 5419417
Cust Vat Reg: 4500213352 Membership No:

Code Qty ICD 10 Description Rate Amount


56.1
9301 1 Z46.3 Casting of model in plaster/ or digital 60.00 60.00
per model
9327 2 Z46.3 Infection control per impression 40.00 80.00
9315 1 Z46.3 Models with die/ analog / digital 230.00 230.00
9787 1 Z46.3 Customising,waxing, milling of implant 820.00 820.00
abutment
9786 1 Z46.3 Working on implants 420.00 420.00
9312 1 Z46.3 Gingival tissue mask per implant 320.00 320.00
9761/TZIT 1 Z46.3 Translucent Zirconia* 370.00 370.00
9505 1 Z46.3 Ceramic bonded crown/pontic 2,430.00 2,430.00
(Feldspatic Porcelain CE 0124/0123)
9330 1 Z46.3 Delivery charge per completed 130.00 130.00
procedure
Monolithic zir restoration crown on 4,860.00
implant

9736 062.4935 1 Z46.3 BLX Variobase for crown abutment(24) 1,740.00 1,740.00
9736 065.0021 1 Z46.3 BLX Implant Analog(24) 640.00 640.00

Unit and Amount includes VAT @ 15%


Subtotal R6,295.65
Please note that the final price may vary from the quote.

This is just an estimation.


VAT Total R944.35

Warning: Some patients may show a sensitivity to the materials used in the custom made device.
This custom made device meets the requirements as set by the medical devices regulator.
Total R7,240.00

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