Page 85 - Appendices to Donald Pender's Evaluation
P. 85
VISION
Routine eye exam $0 copay Limits apply
Contact lenses $0 copay Limits apply
Eyeglasses (frames & Not covered
lenses)
Eyeglass frames only $0 copay Limits apply
Eyeglass lenses only $0 copay Limits apply
Upgrades Not covered
MEDICALLY-APPROVED NON-OPIOID PAIN MANAGEMENT SERVICES
Chiropractic services Not covered
Acupuncture Not covered
Massage therapy Not covered
Alternative therapies Not covered
