Spherocylinder, single vision, plus or minus 4.25d to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens
Short Description: Spherocylinder 4.25d/2.12-4d
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1985
Effective Date: October 1, 2003
Termination Date: