Non-Preferred Provider Coverage
{"Image DocumentName": "Non-Preferred Provider Coverage", "Image ImageDescription": "Member responsible for payment of services to a non-preferred provider. Remit itemized paid receipt to VSP within six months from date of service. Reimbursed the below allowances (copays do apply) Exam- Up to  45. Single Lenses- Up to  45. Bifocals- Up to  65. Trifocals- Up to  85. Frame- Up to  47. Contact Lenses- Up to  105.", "Image XResolution": "37", "Image YResolution": "37", "Image ResolutionUnit": "Pixels/Centimeter", "Image Software": "SlidePlayer", "Image YCbCrPositioning": "Centered"}