| 28667-4 | Right eye Visual acuity far (phoropter) |
| 28710-2 | Left eye Visual acuity far (phoropter) |
| 28791-2 | Left corrective lens Visual acuity far (lensmeter) |
| 28831-6 | Right glasses lens prescription Visual acuity far |
| 28847-2 | Left glasses lens prescription Visual acuity far |
| 28890-2 | Right contact lens Visual acuity far |
| 28914-0 | Left contact lens Visual acuity far |
| 28941-3 | Right contact lens prescription Visual acuity far |
| 28968-6 | Left contact lens prescription Visual acuity far |
| 55979-9 | Right corrective lens Visual acuity far (lensmeter) |