This technical report presents the results of the 2023 Real World Testing for version 5.0 of the Tebra (Kareo) EHR solution. The document outlines the testing measures employed, the timeline for testing activities, and the findings from various metrics tracked during the testing period. The report indicates that the EHR solution performed as certified in a production environment, with no non-conformities or errors discovered during the testing process. It details specific measures such as the number of transition of care C-CDAs sent, C-CDAs received, NewRx prescription messages sent, and patient portal access metrics. Additionally, the report includes updates on the Standards Version Advancement Process (SVAP) and discusses the ongoing efforts to meet Cures Update requirements for future testing. The findings suggest that while certain functionalities were successfully tested, there is a need for increased engagement with clients to enhance the use of the EHR features. Overall, the report serves as a comprehensive account of the testing outcomes for the specified period.