Slab off prism, glass or plastic, per lens
Short Description: Glass/plastic slab off prism
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1985
Effective Date: October 1, 2003
Termination Date:
Short Description: Glass/plastic slab off prism
Coverage Code: Carrier judgment
Action Code: No maintenance for this code
Date Added: January 1, 1985
Effective Date: October 1, 2003
Termination Date: