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Benefits

DC 37 Health & Security Plan Benefits

DC 37 Optical Fee Schedule

Optical Fee Schedule effective November 8, 2002.
 
DESCRIPTION
 FEE

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.

 


*Download Acrobat Reader to view and print PDF files.

 

$ 6.00
9.00
16.00
20.00
16.00
5.00
40.00
65.00
14.00
45.00

 

 

 
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