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Resolution of Intent to Adopt the 2004 -05 Orange County Budget <br />Dental Health Fees <br />Service Title <br />Proposed <br />Fee <br />1st Intraoral PA Film <br />$23 <br />Additional PA Film <br />$21 <br />Intraoral Occulusal Film <br />$24 <br />BWX 1 Film <br />$24 <br />BWX Each Additional Film <br />$18 <br />Pro h /Adult age 13 and u <br />$57 <br />Pro h /Child under age 13 <br />$39 <br />Fluoride Varnish (age 21 &under <br />$27 <br />Periodic Oral Exam <br />$38 <br />Comprehensive Oral Exam <br />$41 <br />Amalgam one Surface Prim <br />$70 <br />Sedative Filling <br />$64 <br />Pin Retention /tooth <br />$26 <br />Put otom <br />$92 <br />Perio Scale Root Plane 1 -4 Per <br />Quad <br />$96 <br />Full mouth Debridement <br />$82 <br />Biopsy Oral Tissue <br />$130 <br />Alveoplasty extractions p/ quad. <br />$70 <br />Palliative Treatment <br />$53 <br />Consultation <br />$47 <br />• Recreation and Parks Facility Rental Fees will remain as approved in fiscal year 2003 -04. The <br />chart below outlines those fees: <br />Facility Rentals <br />Gyms - Group Rentals <br />$25.00 per session <br />Gyms- Open play individuals <br />$2.00 per participant <br />Meeting Rooms <br />$30.00 per hour <br />Ball fields for tournaments <br />$125.00 per weekend <br />• Rental fees for other Recreation and Parks facilities including picnic shelters and picnic tables <br />are not to be charged to users until the Board of County Commissioners approves a fee <br />schedule for such rentals. <br />Page 5 of 5 <br />