V2109 Spherocylinder 4.25d/4.25-6d

Spherocylinder, single vision, plus or minus 4.25 to plus or minus 7.00d 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