| 98498-9 | L eye VA--uncorr | |
| 98499-7 | R eye VA--uncorr | |
| 98500-2 | Eye VA.binoc--uncorr | |
| 98501-0 | L eye Near VA--uncorr | |
| 98502-8 | R eye Near VA--uncorr | |
| 98503-6 | Eye Near VA.binoc--uncorr | |
| 98504-4 | L eye Far VA--uncorr | |
| 98505-1 | R eye Far VA--uncorr | |
| 98506-9 | Eye Far VA.binoc--uncorr | |
| 65893-0 | R eye VA--corr | |
| 65897-1 | L eye VA--corr | |
| 98507-7 | Eye VA.binoc--corr | |
| 98508-5 | L eye Near VA--corr | |
| 98509-3 | R eye Near VA--corr | |
| 98510-1 | Eye Near VA.binoc--corr | |
| 98511-9 | L eye Far VA--corr | |
| 98512-7 | R eye Far VA--corr | |
| 98513-5 | Eye Far VA.binoc--corr | |
| 79908-0 | Type of Visual acuity exam method | |
| 98497-1 | Visual acuity Pnl | |