Description - DE Medical Assistance Program

V2310 LENS SPHC TRIFOCAL 4.25-7/>6 3 $88.00
V2311 LENS SPHC TRIFO 7.25-12/.25- 3 $79.49
V2312 LENS SPHC TRIFO 7.25-12/2.25 3 $79.95
V2313 LENS SPHC TRIFO 7.25-12/4.25 3 $82.94
V2314 LENS SPHCYL TRIFOCAL OVER 12 3 $106.56
V2315 LENS LENTICULAR TRIFOCAL 3 $94.65
V2316 LENS LENTICULAR NONASPHERIC O $0.00
V2317 LENS LENTICULAR ASPHERIC TRI O $0.00
V2318 LENS ANISEIKONIC TRIFOCAL 3 $148.07
V2319 LENS TRIFOCAL SEG WIDTH > 28 3 $52.52
V2320 LENS TRIFOCAL ADD OVER 3.25D 3 $55.41
V2321 LENTICULAR LENS, TRIFOCAL 6 $0.00
V2399 LENS TRIFOCAL SPECIALITY 6 $0.00
V2410 LENS VARIAB ASPHERICITY SING 3 $82.58
V2430 LENS VARIABLE ASPHERICITY BI 3 $92.26
V2499 VARIABLE ASPHERICITY LENS 6 $0.00
V2500 CONTACT LENS PMMA SPHERICAL 3 $85.97
V2501 CNTCT LENS PMMA-TORIC/PRISM 3 $116.84
V2502 CONTACT LENS PMMA BIFOCAL 3 $153.78
V2503 CNTCT LENS PMMA COLOR VISION 3 $148.27
V2510 CNTCT GAS PERMEABLE SPHERICL 3 $116.23
V2511 CNTCT TORIC PRISM BALLAST 3 $150.69
V2512 CNTCT LENS GAS PERMBL BIFOCL 3 $185.42
V2513 CONTACT LENS EXTENDED WEAR 3 $151.11
V2520 CONTACT LENS HYDROPHILIC 3 $107.68
V2521 CNTCT LENS HYDROPHILIC TORIC 3 $169.90
V2522 CNTCT LENS HYDROPHIL BIFOCL 3 $151.60
V2523 CNTCT LENS HYDROPHIL EXTEND 3 $149.83
V2530 CONTACT LENS GAS IMPERMEABLE 3 $202.40
V2531 CONTACT LENS GAS PERMEABLE 3 $421.66
V2599 CONTACT LENS/ES OTHER TYPE 6 $0.00
V2600 HAND HELD LOW VISION AIDS 6 $0.00
V2610 SINGLE LENS SPECTACLE MOUNT 6 $0.00
V2615 TELESCOP/OTHR COMPOUND LENS 6 $0.00
V2620 PROSTHETIC, EYE, GLASS, STOCK 9 $0.00
V2621 PROSTHETIC, EYE PLASTIC, STOCK 9 $0.00
V2622 PROSTHETIC, EYE, GLASS, CUSTOM 9 $0.00
V2623 PLASTIC EYE PROSTH CUSTOM 3 $712.05
V2624 POLISHING ARTIFICAL EYE 3 $64.39
V2625 ENLARGEMNT OF EYE PROSTHESIS 3 $293.59
V2626 REDUCTION OF EYE PROSTHESIS 3 $158.26
V2627 SCLERAL COVER SHELL 3 $1,022.12
V2628 FABRICATION & FITTING 3 $241.34
V2629 PROSTHETIC EYE OTHER TYPE 6 $0.00
V2630 ANTER CHAMBER INTRAOCUL LENS 6 $0.00
V2631 IRIS SUPPORT INTRAOCLR LENS 6 $0.00
V2632 POST CHMBR INTRAOCULAR LENS 6 $0.00
V2700 BALANCE LENS 3 $42.70
V2702 DELUXE LENS FEATURE 9 $0.00