Smart Link Sample Summary Report Intelli Pap Standard

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Smart Link Sample Summary Report IntelliPap Standard

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Smart Link Sample Summary Report Intelli Pap Standard

  1. 1. HME Homecare Products Provider Information Referring Physician Address: 1086 Main Street Name: Allen Jones, MD City: Somerset Group: Sleep Center of Somerset State/Province: PA Address: 19876 Mountain Drive Country: USA City: Somerset Phone Number: 434-333-4343 State/Province: PA Contact: Julie Robertson Postal Code: 15501 Contact: Megan Fairfield Patient Information First Name: Steven Last Name: Jones Address: 1234 Oak Street City: Somerset State/Province: PA Postal Code: 15501 Country: Phone Number: 333-333-3333 Birth Date: Height: Weight: Gender: Male Payor Name: PayPlan One Insurance Id: 1201920 Patient Record: sj-5229892938 Study Details - ID000101 (IntelliPAP Standard) Start Date: 2/1/08 Study Length ( Days ): 60 Pressure Unit : cmH2O CPAP Pressure : 10 Delay Pressure : 4 Delay Time (minutes): 20 Usage Statistics ( 6/1/08 - 8/12/08 ) Possible Usage Days in Range: 73 Usage Index: 92% Days with any Usage: 73 Average Usage Duration (Hours): 4.9 Days used at least 4 hours: 67 Standard Deviation (Hours): 0.6 Page 1 of 2 Created by SmartLink Report Generator Rev.1.5.0 11/5/08
  2. 2. Notes - 11/5/08 - Device ID000101 was assigned to patient - 11/5/08 - First data received for study Page 2 of 2 Created by SmartLink Report Generator Rev.1.5.0 11/5/08

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