Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.12-016 - Visual Care Update 1-12

Universal Citation: AR Admin Rules 016.06.12-016

Current through Register Vol. 49, No. 9, September, 2024

Section II Visual Care

215.000 Eyeglasses Covered by Medicaid

Brand

Frame

Gender

Size

Colors

Europa

ALT-07

Men's

52 and 54

Brown, Gold and Grey

Kerry

Unisex

48 and 50

Bronze, Black, Chrome

Kip

Women's

48

Black and Crystal

MM-01

Children's

38,40 and 42

Brown, Blue, Violet and Pink

MM-02

Children's

39, 41 and 43

Bronze, Blue, Gunmetal and Wine

MM-03

Unisex

46, 48 and 50

Bronze, Black, Gunmetal and Light Copper

MM-04

Unisex

44, 46 and 48

Brown, Blue, Violet and Red

MM-05

Women's

45, 47 and 49

Brown, Black, Gunmetal and Blue

NF-3

Unisex

44 and 46

Matte Black and Matte Silver

L-Cable

Children's

36,38 and 40

Brown, Gold and Black

NF-2

Unisex

45 and 47

Matte Black and Matte Blue

MM-06

Men's

50, 52 and 54

Brown, Black, Gunmetal and Gold

Kenmark

Andrea

Women's

49

Rose, Brown and Wine

Shannon

Women's

46 and 48

Sand, Black and Lavender

Sharon

Women's

49

Black Crystal and Brown

Blaire

Women's

50 and 52

Golden Rose, Nutmeg and Dove

Gypsy

Women's

55 and 57

Demi, Black and Lavender

Sam

Men's

49 and 51

Brown, Gunmetal and Black

Gracy

Women's

52 and 54

Brown, Bleu and Rose

Henry

Men's

52, 54, 56 and 58

Gold, Gold/Demi Amber and Gunmetal/Tortoise

Chet

Men's

54 and 56

Brown and Gunmetal

Aimee

Women's

54 and 56

Brown, Purple and Rose

Gwen

Women's

51 and 53

Beige, Blush and Mist

Debbie

Women's

52

Tortoise and Black

Jim

Men's

53, 55 and 59

Brown, Gunmetal and Gold

Bryant

Men's

49 and 51

Black, Brown and Gunmetal

Leya

Women's

45 and 47

Brown, Grape, Black and Plum

United

Destiny

Unisex

47

Coffee, C2 Matte Black and C3 Matte Silver

Steve

Men's

49 and 51

C1 Brown, and C2 Dark Gray

Stella

Women's

51

C1 Light Brown C2 Lilac and C3 Matte Silver

Candy

Unisex

45

C1 Shiny Brown and C2 Matte Black

Modern

Sporty

Kids

44 and 46

Black/Crystal, Blue and Brown

Gift

Women's

47 and 49

Black/Crystal, Brown/Crystal and Purple/Brown

Dazzle

Women's

49, 51 and 53

Brown, Gold And Rose

Judi

Women's

50 and 53

Black/Crystal, Tortoise and Wine/Gray

Dynamite

Girl's

42, 45 and 47

Antique Brown and Black Silver

Ralph

Men's

52, 54 and 56

Black, Brown and Gray

Ninja

Unisex

44 and 46

Blue, Brown and Lilac

Zimco

Attitudes #3

Women's

50

Brown/Crystal and Black

Retro#1

Women's

48

Gold, Gunmetal Blue and Matte Brown

Hart

Hart-9756

Women's

48

Brown, Gold and Gunmetal Silver

3766

Women's

52

Brown and Lilac

Hart-8112

Unisex

48

Matte Black, Matte Burgundy and Matte Coffee

Reality-Hart

Women's

51

Onyx-Brown and Onyx-Burgundy

3714

Women's

52

Black-Burgundy and Tortoise

Hart-3712

Men's

52

Black-Brown and Gunmetal

7206

Girl's

52

Brown and Graphite

Hart-9751

Women's

48 and 50

Brown, Silver and Lilac

Hart-9509

Boy's

38, 41 and 44

Gold Brown, Satin Blue and Shiny Brown

MiraFlex

Mini Baby

Children

Various

Various Colors

Baby Lux

Children

Various

Various Colors

New Baby 2

Children

Various

Various Colors

LBI

Woman Day

Women's

55

Gold, Rose and Gray

LBI--915

Women's

53

Gold/Silver, Silver/Gold and Brown/Gold

Disclaimer: These regulations may not be the most recent version. Arkansas may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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