GEMS 2017 TARIFF FILE (Scheme Published 28 …

1 GEMS 2017 TARIFF FILE (Scheme Published 28 december 2016 )Change Code DescriptionTariff 201711001 Optometric Examination R Optometric Examination and Visual Field ScreeningR Optometric Re-Examination within six months of 11001/11081R Consultation (15 minutes) without performing an Optometric ExaminationR Cycloplegic RefractionR Preferential Looking (Infants < Two Years)R Corneal TopographyR GonioscopyR Dilated Fundus Examination / BIOR Visual Field - EvaluationR Visual Field - Threshold TestingR Colour Vision EvaluationR Contrast Sensitivity EvaluationR Lacrimal System EvaluationR Photography of Anterior SegmentR Photography of FundusR Diagnostic and Photographic MaterialsN/A11702 PachymetryR Optical Coherence Tomography (OCT)R Visual Evoked Potentials (VEP) - UnilateralR Visual Evoked Potentials (VEP) - BilateralR Refractive Status EvaluationR Ocular Pathology ScreeningR KeratometryR Tonometry (Non-contact)

2 R Tonometry (Aplanation)R Colour Vision ScreeningR Visual Field - ScreeningR Dispensing Fee - Single VisionR Dispensing Fee - BifocalsR Dispensing Fee - VarifocalsR After Hours or Away from Practice VisitN/A11729 Broken Appointments N/A11809 Screening School (per hour)R Screening Industrial (per hour)R C Lens Consultation Basic - per 30 minutesR C Lens Consultation Complex - per 30 minutesR C Lens Consultation Advanced - per 30 minutesR C Lens Consultation - Therapeutic - per 30 minutesR C Lens follow-up Examination/Basic Case - per 30 minutesR C Lens follow-up Examination/Complex Case - per 30 minutesR C Lens follow-up Examination/Advanced Case - per 30 minutesR C Lens Follow-up Therapeutic - per 30 minutesR C Lens Related Problems Assessment - MonocularR C Lens Related Problems Assessment- Binocular R C Lens InstructionR C Lens Dispensing and/or AssessmentR Binocular

3 Instability evaluation - Simple CaseR Binocular Instability evaluation - Complex CaseR Visually Related Learning Disorders EvaluationR 1 Eye Movements evaluation ( Visigraph) R Reading Rate- screeningR Reading Ortho-Didactical skills evaluationR Colorimetry Intuitive - evaluationR Vision Training - Home Therapy InstructionR Vision Training - Individual (per 15 minutes)R Vision Training - Individual (per 30 minutes)R Vision Training - Group per Patient (per 15 minutes)R Vision Training - Away From Practice (add to 13423 or 13463)N/A16013 Low Vision Assessment per 30 minsR Low Vision Training per 30 mins R Sports Vision Individual ScreeningR Sports Vision Individual EvaluationR Sports Vision Individual Training (per 15 minutes)R Sports Vision Group ScreeningR Sports Vision Group EvaluationR Sports Vision Group Training (per 15 minutes)R 2017 TARIFF FILE (Scheme Published 28 december 2016 )14309 Sports Vision Individual ScreeningR Sports Vision Individual EvaluationR Sports Vision Individual Training (per 15 minutes)

4 R Sports Vision Group ScreeningR Sports Vision Group EvaluationR Sports Vision Group Training (per 15 minutes)R Report at request of Medical Report at Patient's request (arising from Series 11001)R Contact Lens Solutions R Contact Lens Accessories R Hard Contact LensR Rigid Scleral Contact lensR Fenestration Hard Lens (per hole)R Truncation Hard LensR Bifocal Hard LensR Laboratory Service / Modification / PolishR Analysis of Hard LensR Kerasoft IC 77%R Kerasoft 2 49%R BIO-Colours 38% Conventional Custom-Colours (Sphere)R BIO-Colours 38% Conventional Custom-Colours (Toric)R CLL HEMA (up to 60%)R CLL HWC (higher than 60%)R CLL Contaflex 38% ProstheticR CLL Soft Haptic 38% ProstheticR CLL Dark Brown Iris Black Pupil ProstheticR CLL Field Eyes (sports tint)R CLL Enhancing Iris TintR CLL Hand Painted TheatricalsR CLL Photo-phobicR CLL Albino IrisR Soflex Soft K 67% (Hydrogel) - For KeratoconusR Soflex Soft K 67% RG (Hydrogel) - For KeratoconusR Soflex Soft K 67% Toric (Hydrogel)

5 - For KeratoconusR Soflex Eye Q MultifocalR Soflex Toric Eye Q MultifocalR Soflex CDGM3 SphericR Soflex CDGM3 ToricR Soflex Toric Lite (TLITE 58%)R Soflex Expo AsphericR Proclear SphereN/A27200 Proclear Sphere RxR Zero 6 Zero 6 RxR Proclear TMTR Z6 Rx ToricR Hydrasoft ToricN/AX27255 Omniflex ToricN/A27358 Alden Novakone SphereR Alden Novakone ToricR Alden HP Sphere 59R Alden HP Toric 59R Alden VERSA LensR UltravisionR Soft SphericalR Soft ToricR Soleko SL 38 StandardR Soleko SL 38 ColorR Biogel 60 percent R Biogel 72 percentR Hydrowave Spher/ToricR Kerasoft 2R Kerasoft IC (KIC)

6 R Kerasoft 3R HYDROSOFT Toric - YearlyR Synergeyes AR Synergeyes KCR Synergeyes PSR 2017 TARIFF FILE (Scheme Published 28 december 2016 )27806 Synergeyes CKR Duette R Duette MultifocalR Ultra Health - KerataconusR Cosmetic TintR Intensive Cleaning of LensR Analysis of Soft Lens R AIR OPTIX AQUAR AIR OPTIX NIGHT & DAYTM AQUAR AIR OPTIX NIGHT & DAYTM AQUAR AIR OPTIX for ASTIGMATISMR AIR OPTIX COLORS R AIR OPTIX AQUA MultifocalR DAILIES AquaComfort Plus (Sphere)R DAILIES AquaComfort Plus (Sphere)R DAILIES AquaComfort Plus TORICR DAILIES AquaComfort Plus MULTIFOCALR DAILIES TOTAL 1 R DAILIES TOTAL 1 R Freshlook One-DayR Freshlook IlluminateR Freshlook ColorsR Freshlook ColorBlendsR Freshlook DimensionsR Freshlook DimensionsR SofLens 59R Soflens 38R Soflens ToricR Soflens Natural ColoursR Soflens Multi-FocalR PureVision R PureVision 2 HDR PureVision 2HD for AstigmatismR PureVision 2 For PresbyopiaR PureVision ToricR PureVision Multi-FocalR Soflens Daily DisposableR Soflens Daily DisposableR Soflens Daily Disposable for

7 AstigmatismR Biotrue ONEdayR Biotrue ONEdayR Biotrue ONEday For PresbyopiaR UltraR Premio 2 week Toric (Silicone Hydrogel) - COMING SOONR Premio 2 week Sphere (Silicone Hydrogel) - COMING SOONR Miru 1 month - COMING SOONR Miru 1 day - COMING SOONR Miru 1 day - COMING SOONR Kerasoft IC (Silicone Hydrogel 74%)R Kerasoft 3 77%R Creations MonthlyR Adore Coloured 3 month Disposable (Rx from -10 to +16)R Soflex Kristal Colour DisposableR Soflex Colour 4 Fun CosmeticR CLL Silicone Hydrogel Sphere (INFANTS)R CLL Silicone Hydrogel SphereR Soflex theraputic lens (Silicone Hydrogel) - For pediatric aphakicR Soflex Soft K (Silicone Hydrogel) - For KeratoconusR Soflex Soft K Toric (Silicone Hydrogel) - For KeratoconusR Soflex Soft K RG (Silicone Hydrogel) - For KeratoconusR Soflex Soft K Semi Scleral (Silicone Hydrogel) - For KeratoconusR Soflex Soft K Toric Semi Scleral (Silicone Hydrogel) - For KeratoconusR Soflex Toric (Silicone Hydrogel) R Soflex Sphere (Silicone Hydrogel)R Soflex Dispo Air Multifocal (Silicone Hydrogel)R Soflex Dispo Bio (Silicone Hydrogel)

8 R Soflex Dispo Bio Toric (Silicone Hydrogel)R Soflex Dispo MultifocalR 2017 TARIFF FILE (Scheme Published 28 december 2016 )28923 CLL Dispo "Enhancing Colours" (Green / Blue / Aqua)R Soflex DispoR Soflex Dispo AsphericR Soflex Dispo ProR Soflex Dispo Pro ToricR Soflex Dispo Silk One DayR Soflex Dispo Silk Toric One DayR Soflex Dispo ToricR Soflex Eye Q Multifocal (Silicone Hydrogel)R Soflex Toric Eye Q Multifocal (Silicone Hydrogel)R Soflex Kristal MonthlyR Soflex Trios Back ToricR Soflex Dispo Day by DayR BiofinityR Biofinity Sphere XRR AvairaR Proclear CompatiblesR Frequency XC (To be discontinued October 2016 )R Frequency AsphericR Biofinity ToricR Biofinity Toric XR (coming soon)R Proclear ToricR Proclear Toric XRR Frequency Xcel ToricR Frequency Xcel Toric XRR Proclear 1 day R Proclear 1 day R MyDayR MyDay (coming soon)

9 R Proclear 1 Day MultifocalR Biomedics 1 Day toricR Clariti 1 Day SphereR Clariti 1 Day ToricR Clariti 1 Day MultifocalR Biofinity MultifocalR Proclear Multifocal R Proclear Multifocal XRR Proclear Multifocal ToricR Proclear Multifocal Toric TrialsR Expressions Colors (3 Pack)R Color Tones (To to discontinued November 2016 )R clear1-dayR clear1-dayR clear1-dayR clearday Beyond1-dayR clearday Beyond1-dayR clearday Beyond1-dayR clearall-dayR clearall-dayR clearall-day ToricR clearall-day ToricR clear58R clear58R clearday BeyondR clearday BeyondR clearday Beyond for AstigmatismR clearday Beyond for AstigmatismR clearcolor1-dayR clearcolor1-dayR clearcolor R clearcolor R DaySoft SILKR DaySoft SILKR Soleko Queen Solitaire sphericR Soleko QueenColor ToricR Neovision Neoclean Clear R Neovision Eyepia Clear R Neovision 3 Tone Colour R 2017 TARIFF FILE (Scheme )

10 Published 28 december 2016 )28566 Neovision 2 Tone Colour R Neovision Costume Lenses R SIGMA RX G3/G4/G5 SphericR SGF Comfort Spheric R SL55 SphericR SL 3 Spheric R SL38 ToricR SIGMA RX G3/G4/G5 Toric R SGF Comfort ToricR ST3 ToricR Poly Vue RX Custom Multifocal R SIGMA Mult