Eye Examination ...................................................................
Single Vision Lenses (Standard lenses) ...................................
Bifocal Lenses (Standard lenses) ............................................
Trifocal Lenses (Standard lenses) ...........................................
Progressive Lenses (Standard lenses) .....................................
Frame ..................................................................................
Plastic Aspheric Single Vision Cataract Lenses .........................
Plastic
Aspheric Bifocal Cataract Lenses ..................................
Contact
Lenses .....................................................................
Cataract Contact Lenses*.......................................................
*If you are Medicare eligible, you must use Medicare as the primary (first)
carrier when you submit a claim for cataract lenses. In addition, if you use the
Vision Center for this service, a claim must be completed and submitted for processing
to Medicare.

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