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System Administrator
Provider Information                            Referring Physician
Address:                                        Name:                     Dr. Haversham
City:                                           Group:                    Sleep Specialists
State/Province:                                 Address:                  1234 30th Street
Country:                                        City:                     Somerset
Phone Number:                                   State/Province:           PA
Contact:                                        Postal Code:              15501
                                                Contact:                  Jenny Smith


Patient Information
First Name:           Adam
Last Name:            Fairchild
Address:              2234 Oak Lane
City:                 Somerset
State/Province:       PA
Postal Code:          15501
Country:              USA
Phone Number:         333-333-3333
Birth Date:           8/18/63
Height:               5'9quot;
Weight:               190
Gender:               Male
Payor Name:           Healthcare Insurrer
Insurance Id:         389w982
Patient Record:       982097sli

Study Details - HD000100 (IntelliPAP AutoAdjust)
Start Date:                                     8/1/08
Study Length ( Days ):                          60
Pressure Unit :                                 cmH2O
Lower Pressure Limit :                          5
Upper Pressure Limit :                          15
AutoAdjust Delay Time (minutes):                20




Page 1 of 2                                 Created by SmartLink Report Generator Rev.1.5.0 10/26/08
8/2/08 9:48 PM - 8/3/08 5:28 AM




              Events Summary (Delay Mode)                                 Events Summary (AutoAdjust Mode)
Time           1 Hours      Mask Leak         0 % of total       Time         6.7 Hours      Mask Leak         0 % of total
                            Time                                                             Time
AHI            4 Per Hour   Exhale Puffs      1 Per Hour         AHI          2.1 Per Hour   Exhale Puffs      7.9 Per Hour
AI             2 Per Hour   Average           8 cmH2O            AI           0.9 Per Hour   Average           13.5 cmH2O
                            Pressure                                                         Pressure
HI             2 Per Hour   Average Leak      38.1 L/min         HI           1.2 Per Hour   Average Leak      45.8 L/min
NI             0 Per Hour   Avg. Est. Tidal   608.3 mL           NI           0.1 Per Hour   Avg. Est. Tidal   729 mL
                            Vol.                                                             Vol.
Snores         37 Events    Avg. Breath       15 bpm             Snores       154 Events     Avg. Breath       13.5 bpm
                            Rate                                                             Rate




Page 2 of 2                                                  Created by SmartLink Report Generator Rev.1.5.0 10/26/08

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Smart Link Sample Single Night Intelli Pap Auto Adjust

  • 1. System Administrator Provider Information Referring Physician Address: Name: Dr. Haversham City: Group: Sleep Specialists State/Province: Address: 1234 30th Street Country: City: Somerset Phone Number: State/Province: PA Contact: Postal Code: 15501 Contact: Jenny Smith Patient Information First Name: Adam Last Name: Fairchild Address: 2234 Oak Lane City: Somerset State/Province: PA Postal Code: 15501 Country: USA Phone Number: 333-333-3333 Birth Date: 8/18/63 Height: 5'9quot; Weight: 190 Gender: Male Payor Name: Healthcare Insurrer Insurance Id: 389w982 Patient Record: 982097sli Study Details - HD000100 (IntelliPAP AutoAdjust) Start Date: 8/1/08 Study Length ( Days ): 60 Pressure Unit : cmH2O Lower Pressure Limit : 5 Upper Pressure Limit : 15 AutoAdjust Delay Time (minutes): 20 Page 1 of 2 Created by SmartLink Report Generator Rev.1.5.0 10/26/08
  • 2. 8/2/08 9:48 PM - 8/3/08 5:28 AM Events Summary (Delay Mode) Events Summary (AutoAdjust Mode) Time 1 Hours Mask Leak 0 % of total Time 6.7 Hours Mask Leak 0 % of total Time Time AHI 4 Per Hour Exhale Puffs 1 Per Hour AHI 2.1 Per Hour Exhale Puffs 7.9 Per Hour AI 2 Per Hour Average 8 cmH2O AI 0.9 Per Hour Average 13.5 cmH2O Pressure Pressure HI 2 Per Hour Average Leak 38.1 L/min HI 1.2 Per Hour Average Leak 45.8 L/min NI 0 Per Hour Avg. Est. Tidal 608.3 mL NI 0.1 Per Hour Avg. Est. Tidal 729 mL Vol. Vol. Snores 37 Events Avg. Breath 15 bpm Snores 154 Events Avg. Breath 13.5 bpm Rate Rate Page 2 of 2 Created by SmartLink Report Generator Rev.1.5.0 10/26/08