| 97328-9 | Interval between surgery and examination | |
| 97888-2 | Which of the following problems related to your back condition troubles you the most:Find:Pt:^Patient:Ord: | |
| 97339-6 | Pain severity + Body site Pnl | |
| 97339-6 | Pain severity + Body site Pnl | |
| 97330-5 | Hlth cond interfere with normal work past W | |
| 97331-3 | If you had to spend the rest of your life with the symptoms you have right now how would you feel about it:Find:Pt:^Patient:Ord: | |
| 97332-1 | Quality of life in past W | |
| 97333-9 | #D cut down activities hlt cond 4W | |
| 97334-7 | #D didn't go to work due to health cond | |
| 97335-4 | Type of postoperative complication | |
| 97336-2 | Postop complication distress level | |
| 97337-0 | Subsequent operation for same condition | |
| 77218-6 | Pt satisfaction w healthcare | |
| 97338-8 | Treatment effectiveness | |
| 30947-6 | Date form completed | |
| 70127-6 | Signature verifying assessment completion:Pn:Pt:^Patient:Nom: | |
| 97889-0 | Core Outcome Measures Index for the Back score:Score:Pt:^Patient:Qn:COMI | |
| 97887-4 | Core Outcome Measures Index for the Back:-:Pt:^Patient:-:COMI | |