diff --git a/packages/zambdas/package.json b/packages/zambdas/package.json
index 35f05d6137..1f80c9af62 100644
--- a/packages/zambdas/package.json
+++ b/packages/zambdas/package.json
@@ -66,7 +66,8 @@
     "remove-payor-orgs": "tsx src/scripts/remove-payor-orgs.ts",
     "update-locations-for-lab-accounts": "tsx src/scripts/labs/update-locations-for-lab-accounts.ts",
     "sync-lab-specimen-dates": "tsx src/scripts/labs/sync-specimen-dates.ts",
-    "reset-lab-order": "tsx src/scripts/labs/reset-lab-order.ts"
+    "reset-lab-order": "tsx src/scripts/labs/reset-lab-order.ts",
+    "restore-appointment-observations": "tsx src/scripts/restore-appointment-observations.ts"
   },
   "engines": {
     "node": ">=22.0.0",
diff --git a/packages/zambdas/src/scripts/restore-appointment-observations.ts b/packages/zambdas/src/scripts/restore-appointment-observations.ts
new file mode 100644
index 0000000000..48fe83557f
--- /dev/null
+++ b/packages/zambdas/src/scripts/restore-appointment-observations.ts
@@ -0,0 +1,216 @@
+import Oystehr, {
+  BatchInputGetRequest,
+  BatchInputPostRequest,
+  BatchInputPutRequest,
+  BatchInputRequest,
+  FhirSearchParams,
+} from '@oystehr/sdk';
+import { FhirResource } from 'fhir/r4b';
+import {
+  ChartDataResources,
+  EXAM_OBSERVATION_META_SYSTEM,
+  flattenBundleResources,
+  isFollowupEncounter,
+  OTTEHR_MODULE,
+  PRIVATE_EXTENSION_BASE_URL,
+} from 'utils';
+import { createFindResourceRequest } from '../ehr/get-chart-data/helpers';
+import {
+  chartDataResourceHasMetaTagBySystem,
+  getAuth0Token,
+  getPatientEncounter,
+  makeExamObservationResource,
+  saveResourceRequest,
+} from '../shared';
+import { createExamObservations } from '../subscriptions/appointment/appointment-chart-data-prefilling/helpers';
+import { fhirApiUrlFromAuth0Audience, performEffectWithEnvFile } from './helpers';
+
+async function recoverObservationsForAppointment(config: any): Promise<void> {
+  const token = await getAuth0Token(config);
+  if (!token) throw new Error('Failed to fetch auth token.');
+  const oystehr = new Oystehr({
+    fhirApiUrl: fhirApiUrlFromAuth0Audience(config.AUTH0_AUDIENCE),
+    accessToken: token,
+  });
+
+  const appointmentsSearchParams: FhirSearchParams<FhirResource> = {
+    resourceType: 'Appointment',
+    params: [
+      { name: '_tag', value: OTTEHR_MODULE.IP },
+      {
+        name: '_sort',
+        value: 'date',
+      },
+      { name: '_revinclude', value: 'Encounter:appointment' },
+      { name: '_revinclude:iterate', value: 'Observation:encounter' },
+    ],
+  };
+
+  // The very first offset is 1900
+  const FIRST_OFFSET = 1900;
+  let total = 1;
+
+  const fixedEncounterIds: string[] = [];
+  const failedEncounterIds: string[] = [];
+
+  // Create a new array to avoid mutating the original params
+  const params = [
+    ...(appointmentsSearchParams.params ?? []),
+    { name: '_count', value: `1` },
+    { name: '_total', value: 'accurate' },
+  ];
+
+  // First, get total count using offset = FIRST_OFFSET
+  {
+    const initialResponse = await oystehr.fhir.search<FhirResource>({
+      resourceType: appointmentsSearchParams.resourceType,
+      params: [...params, { name: '_offset', value: `${FIRST_OFFSET}` }],
+    });
+    total = initialResponse.total || 0;
+    console.log('Total is: ', total);
+  }
+
+  // If the total is less than FIRST_OFFSET, nothing to do
+  if (total <= FIRST_OFFSET) {
+    console.log('Total is less than or equal to FIRST_OFFSET, nothing to process.');
+  } else {
+    const partitionLen = Math.ceil((total - FIRST_OFFSET) / 4);
+    // Parallel threads array
+    const workers: Promise<void>[] = [];
+
+    // Helper processing logic per "thread"
+    const processPartition = async (startIdx: number, endIdx: number): Promise<void> => {
+      let currentIndex = startIdx;
+      while (currentIndex < endIdx && currentIndex < total) {
+        console.log('Current index: ', currentIndex);
+        const bundledResponse = await oystehr.fhir.search<FhirResource>({
+          resourceType: appointmentsSearchParams.resourceType,
+          params: [...params, { name: '_offset', value: `${currentIndex}` }],
+        });
+        const matchedCount = bundledResponse.entry?.filter((entry) => entry.search?.mode === 'match').length || 0;
+        // (Total could in theory change per results, but let's use initial total for partition indices)
+        const unbundled = bundledResponse.unbundle();
+        const examObservations = unbundled.filter(
+          (resource) =>
+            resource.resourceType === 'Observation' &&
+            chartDataResourceHasMetaTagBySystem(
+              resource,
+              `${PRIVATE_EXTENSION_BASE_URL}/${EXAM_OBSERVATION_META_SYSTEM}`
+            )
+        );
+        if (examObservations.length < 141) {
+          const encounterId = unbundled.find((res) => res.resourceType === 'Encounter' && !isFollowupEncounter(res))
+            ?.id;
+          const appointmentId = unbundled.find((res) => res.resourceType === 'Appointment')?.id;
+          if (!encounterId || !appointmentId) {
+            console.log('No encounter or appointment found for index: ' + currentIndex);
+            currentIndex += matchedCount > 0 ? matchedCount : 1;
+            continue;
+          }
+          try {
+            const fixed = await fixEncounterObservations(encounterId, oystehr);
+            if (fixed) {
+              fixedEncounterIds.push(encounterId);
+              console.log('Fixed encounter: ' + encounterId);
+              console.log('Appointment id: ' + appointmentId);
+            } else {
+              failedEncounterIds.push(encounterId);
+              console.log('Failed to fix encounter: ' + encounterId);
+              console.log('Appointment id: ' + appointmentId);
+            }
+          } catch (e) {
+            console.log('Error fixing encounter: ' + encounterId);
+            console.log('Error: ', e);
+            failedEncounterIds.push(encounterId);
+          }
+        }
+        currentIndex += matchedCount > 0 ? matchedCount : 1; // Avoid infinite loops if result is empty
+      }
+    };
+
+    for (let i = 0; i < 4; i++) {
+      const startIdx = FIRST_OFFSET + i * partitionLen;
+      // End index is one past the last for this thread
+      const endIdx = Math.min(FIRST_OFFSET + (i + 1) * partitionLen, total);
+      workers.push(processPartition(startIdx, endIdx));
+    }
+
+    // Wait for all threads to finish
+    await Promise.all(workers);
+  }
+
+  console.log('Fixed encounter ids: ', fixedEncounterIds);
+  console.log('Failed encounter ids: ', failedEncounterIds);
+}
+
+async function fixEncounterObservations(encounterId: string, oystehr: Oystehr): Promise<boolean> {
+  const patientEncounter = await getPatientEncounter(encounterId, oystehr);
+  const patient = patientEncounter.patient;
+  const encounter = patientEncounter.encounter;
+  const chartDataRequests: BatchInputGetRequest[] = [];
+  const saveOrUpdateRequests: (
+    | BatchInputPostRequest<ChartDataResources>
+    | BatchInputPutRequest<ChartDataResources>
+    | BatchInputRequest<ChartDataResources>
+  )[] = [];
+  const obsRequest = createFindResourceRequest(
+    patient,
+    encounter,
+    'Observation',
+    { _search_by: 'encounter' },
+    'encounter'
+  );
+  chartDataRequests.push(obsRequest);
+  const result = await oystehr.fhir.batch<FhirResource>({
+    requests: chartDataRequests,
+  });
+  const existingObservations = flattenBundleResources<FhirResource>(result);
+  // for (const resource of existingObservations) {
+  //   if (
+  //     resource?.resourceType === 'Observation' &&
+  //     chartDataResourceHasMetaTagBySystem(resource, `${PRIVATE_EXTENSION_BASE_URL}/${EXAM_OBSERVATION_META_SYSTEM}`)
+  //   ) {
+  //     // console.log('Observation found: ', resource.id, resource.code?.text);
+  //   }
+  // }
+  // Exam observations
+  const examObservations = createExamObservations(true);
+  for (const element of examObservations) {
+    const { code, bodySite, label, ...rest } = element;
+    if (
+      existingObservations.some(
+        (o) => o.resourceType === 'Observation' && o.meta?.tag?.some((t) => t.code === element.field)
+      )
+    ) {
+      continue; // Observation already exists
+    }
+    saveOrUpdateRequests.push(
+      saveResourceRequest(
+        makeExamObservationResource(encounterId, patient!.id!, rest, code ? { code, bodySite } : undefined, label)
+      )
+    );
+  }
+  const saveOrUpdateResult = await oystehr.fhir.batch<FhirResource>({
+    requests: saveOrUpdateRequests,
+  });
+  if (saveOrUpdateResult.entry?.some((e) => e.response?.outcome?.id !== 'ok')) {
+    console.log('Failed to save or update observations for encounter: ' + encounterId);
+    console.log('SaveOrUpdateResult: ', JSON.stringify(saveOrUpdateResult, null, 2));
+    return false;
+  }
+  return true;
+}
+
+const main = async (): Promise<void> => {
+  try {
+    await performEffectWithEnvFile((config: any) => recoverObservationsForAppointment(config));
+  } catch (e) {
+    console.log('Catch some error while running all effects: ', e);
+    console.log('Stringifies: ', JSON.stringify(e));
+  }
+};
+
+main().catch((error) => {
+  console.log('error', error);
+  throw error;
+});