First American Administrators, Inc.
keratoconus is present and Rx is not correctable to 20/25 in either or both eyes with spectacles Check appropriate ICD-10 code: ☐ H18.601 H18.602 ☐H18.603 ☐ H18.609 ☐ H18.611 ☐ H18.612 ☐ H18.613 H18.619 $ Enter retail price ☐ Check here Keratoconus - advanced/ ectasia 92072AD Select when keratoconus is present and one or more of ...
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