| 28719-3 | Right eye Visual acuity near (phoropter) |
| 28801-9 | Right corrective lens Visual acuity near (lensmeter) |
| 28839-9 | Right glasses lens prescription Visual acuity near |
| 28856-3 | Left glasses lens prescription Visual acuity near |
| 28891-0 | Right contact lens Visual acuity near |
| 28915-7 | Left contact lens Visual acuity near |
| 28942-1 | Right contact lens prescription Visual acuity near |
| 28969-4 | Left contact lens prescription Visual acuity near |
| 55978-1 | Left corrective lens Visual acuity near (lensmeter) |
| 55987-2 | Left eye Visual acuity near (phoropter) |