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DocuSign Envelope ID:881484B7-44A8-4DD9-9947-6209CB23CD79 <br /> 44 PatagoniaHedlth <br /> http://www.patagoniahealth.com <br /> 6. Immunizations (CVX, CPT Codes as applicable) <br /> 7. Problems (ICD-9, ICD-10 CM codes as applicable) <br /> 8. Allergies (SNOMED, FDB codes as applicable) <br /> 9. Medications (FDB Codes) <br /> 10. Lab results <br /> 11. Orders and Procedures. lab, imaging orders (CPT codes) <br /> 12. Patient vitals <br /> 13. Encounter notes (free text, selected elements: Yes/No, Normal/Abnormal etc.) <br /> 14. TB Forms <br /> 15. Maternal Health forms <br /> 16. BCCCP forms <br /> 17. WISEWOMAN forms <br /> 18. Electronic super bills (ICD-9, ICD-10 CM, CPT codes as applicable) <br /> 19. Billing: Primary, secondary insurance. Amount charged for every service. Amount paid by public/private <br /> insurance for each service <br /> These tables correspond to the widgets and tables you see in the EHR. <br /> Data extract will be provided as a MS SQL 2012 database backup file. <br /> Page 3 of 3 <br /> Confidential. CopyrightO 2018 Patagonia Health, Inc. <br />