V2105

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

Short Description: Spherocylinder 4.00d/4.25-6d

Coverage Code: Carrier judgment

Action Code: No maintenance for this code

Date Added: January 1, 1985

Effective Date: October 1, 2003

Termination Date:

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