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SPIROMETRY TEST
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Spirometry Test Indicators
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Supplemental Oxygen Use
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Additional notes to support testing:
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Perform test ONLY if patient has one of the indications above selected.
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Spirometry Conducted
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Test Quality Grade:
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Is the FEV1/FVC result less than 70%?
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What is the FEV1/FVC value of the best test result?
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Spirometry Results
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Bill for Spirometry? ON for Yes
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Photo of Spirometry Test Results
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