| 46496-6 | Agency patient number:ID:RptPeriod:^Patient:Nom:CMS Assessment | |
| 65882-3 | Refractive error device Model # | |
| 65529-0 | Corneal vertex Eye PhenX | |
| 65890-6 | Spherical power InvLen R eye | |
| 65892-2 | Cylindrical power InvLen R eye | |
| 65891-4 | Cylinder axis R eye | |
| 65893-0 | R eye VA--corr | |
| 65894-8 | Spherical power InvLen L eye | |
| 65896-3 | Cylindrical power InvLen L eye | |
| 65895-5 | Cylinder axis L eye | |
| 65897-1 | L eye VA--corr | |
| 65882-3 | Refractive error device Model # | |
| 65890-6 | Spherical power InvLen R eye | |
| 65892-2 | Cylindrical power InvLen R eye | |
| 65891-4 | Cylinder axis R eye | |
| 65894-8 | Spherical power InvLen L eye | |
| 65896-3 | Cylindrical power InvLen L eye | |
| 65895-5 | Cylinder axis L eye | |