The following are not covered: Eyeglasses, ophthalmic lenses, optical aids, and optician services rendered to recipients 21 years old and older; Eyeglasses, ophthalmic lenses, optical aids, and optician services rendered to recipients which were not ordered as a result of a full or partial EPSDT screen; Repairs, except when repairs to eyeglasses are more cost-effective than replacing with new eyeglasses; Combination or metal frames except when required for proper fit; Cost of travel by the provider; A general screening of a Medical Assistance population; Visual training sessions which do not include orthoptic treatment; Routine adjustment. An optometrist certified by the Board as qualified to administer diagnostic pharmaceutical agents may use the following agents in strengths not greater than the strengths indicated: Agents directly or indirectly affecting the pupil of the eye, including the mydriatics and cycloplegics listed below: Phenylephrine hydrochloride (2.5 percent); Hydroxyamphetamine hydrobromide (1 percent); Cyclopentolate hydrochloride (0.5—2 percent); Tropicamide (0.5 and 1 percent); Cyclopentolate hydrochloride (0.2 percent) with Phenylephrine hydrochloride (1 percent); Dapiprazole hydrochloride (0.5 percent); and Hydroxyamphetamine hydrobromide (1 percent) and Tropicamide (0.25 percent); and Agents directly or indirectly affecting the sensitivity of the cornea including the: Topical anesthetics listed below: Proparacaine hydrochloride (0.5 percent); and Tetracaine hydrochloride (0.5 percent); and Diagnostic topical anesthetic and dye combinations listed below: Benoxinate hydrochloride (0.4 percent) — Fluorescein sodium (0.25 percent); and Proparacaine hydrochloride (0.5 percent) — Fluorescein sodium (0.25 percent). An optometrist certified by the Board as qualified to administer and prescribe topical therapeutic pharmaceutical agents is limited to: Ocular antihistamines, decongestants, and combinations of them, excluding steroids; Ocular antiallergy pharmaceutical agents; Ocular antibiotics and combinations of ocular antibiotics, excluding specially formulated or fortified antibiotics; Anti-inflammatory agents, excluding steroids; Ocular lubricants and artificial tears; Tropicamide; Homatropine; Nonprescription drugs that are commercially available; and Primary open-angle glaucoma medications, in accordance with a written treatment plan developed jointly between the optometrist and an ophthalmologist.