V2105 Spherocylinder 4.00d/4.25-6d

Spherocylinder, single vision, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens

• Medicare coverage: Carrier judgment
• Status: active (July 2026 file)
• MUE: max 0 units per day (practitioner), rationale: CMS Policy