3AI Care - IFC Patient Cost Calculator

Patient Information

First Name

Last Name

Date of Birth

Mobile Number

Treating Dentist

Total Clinic Hours Needed

Patient Type

Facility Fee Structure

Per Hour Rate

$ per hour (ex GST)

Fixed Fee

$ total (ex GST)

Medicare Safety Net Status

Current Safety Net Expenditure

Concession Card Holder

Family Tax Benefit A Recipient

Cost Breakdown

Anaesthesia Fee (GST Free)

$0.00

Facility Fee (inc GST)

$0.00

Total Fees

$0.00

Medicare Rebate (GST Free)

$0.00

PATIENT OUT-OF-POCKET COST

$0.00

Detailed Calculation Breakdown