diff --git a/src/lib/medications/__tests__/intake-slot-dedup-isolation.test.ts b/src/lib/medications/__tests__/intake-slot-dedup-isolation.test.ts
index 6d784a435..586640b6b 100644
--- a/src/lib/medications/__tests__/intake-slot-dedup-isolation.test.ts
+++ b/src/lib/medications/__tests__/intake-slot-dedup-isolation.test.ts
@@ -177,3 +177,69 @@ describe("dedupeUserIntakeSlots — per-slot error isolation", () => {
     expect(prisma.medicationIntakeEvent.updateMany).toHaveBeenCalledTimes(2);
   });
 });
+
+/**
+ * v1.20.2 F4 — the per-medication dedup read path is batched. The
+ * pre-v1.20.2 shape issued a `findFirst` (latest takenAt) + a `findMany`
+ * (all rows) PER medication → 2N round-trips. The batched path pulls
+ * every live row for the user's medication set in ONE `findMany`, groups
+ * in memory, and derives the per-med `lastIntakeAt` from the grouped set,
+ * so the read cost is one query regardless of the medication count.
+ */
+describe("dedupeUserIntakeSlots — batched read path (F4)", () => {
+  it("reads every medication's rows in a single findMany and never per-med findFirst", async () => {
+    const MED_2 = { ...MED, id: "med-2" };
+    vi.mocked(prisma.medication.findMany).mockResolvedValue([
+      MED,
+      MED_2,
+    ] as never);
+
+    // Rows for BOTH medications come back in one ordered result set; the
+    // grouping keys them apart by `medicationId`. med-2 carries a single
+    // row (no duplicate slot) so it is a no-op — proving the grouping
+    // routes each med's slice correctly.
+    const med2Row = {
+      id: "r-m2",
+      medicationId: "med-2",
+      scheduledFor: new Date("2026-06-15T05:00:00.000Z"),
+      takenAt: new Date("2026-06-15T05:02:00.000Z"),
+      skipped: false,
+      syncVersion: 0,
+      createdAt: new Date("2026-06-15T00:00:00Z"),
+      attributionSource: "AUTO",
+      inventoryConsumption: null,
+    };
+    // `inventoryConsumption: null` on every row keeps the loser-refund
+    // path (which itself runs a `findFirst` inside `restoreForIntake`)
+    // out of the picture, so the findFirst assertion isolates the removed
+    // lastIntake probe.
+    const med1Rows = seedRows().map((r) => ({
+      ...r,
+      inventoryConsumption: null,
+    }));
+    vi.mocked(prisma.medicationIntakeEvent.findMany).mockResolvedValue([
+      ...med1Rows,
+      med2Row,
+    ] as never);
+    vi.mocked(prisma.medicationIntakeEvent.update).mockResolvedValue(
+      {} as never,
+    );
+
+    const summary = await dedupeUserIntakeSlots("u1");
+
+    // ONE findMany for the whole medication set; the per-med findFirst is
+    // gone entirely.
+    expect(prisma.medicationIntakeEvent.findMany).toHaveBeenCalledTimes(1);
+    expect(prisma.medicationIntakeEvent.findFirst).not.toHaveBeenCalled();
+    // The single read is keyed by the medication-id set, not per med.
+    const whereArg = vi.mocked(prisma.medicationIntakeEvent.findMany).mock
+      .calls[0][0] as {
+      where: { medicationId: { in: string[] } };
+    };
+    expect(whereArg.where.medicationId.in.sort()).toEqual(["med-1", "med-2"]);
+
+    // med-1's two slots still collapse from its grouped slice; med-2's
+    // lone row is left alone.
+    expect(summary.slotsCollapsed).toBe(2);
+  });
+});
diff --git a/src/lib/medications/intake-slot-dedup.ts b/src/lib/medications/intake-slot-dedup.ts
index 073c47db4..328d24c25 100644
--- a/src/lib/medications/intake-slot-dedup.ts
+++ b/src/lib/medications/intake-slot-dedup.ts
@@ -242,25 +242,24 @@ export async function dedupeUserIntakeSlots(
   // recompute after the collapse. Deduped so a busy day folds once.
   const daysToRecompute = new Set<string>();
 
-  for (const med of medications) {
-    if (med.schedules.length === 0) continue;
+  // v1.20.2 F4 — batch the per-medication reads. The pre-v1.20.2 shape
+  // issued a `findFirst` (latest takenAt) + a `findMany` (all live rows)
+  // PER medication → 2N round-trips (20 meds = 40). Pull every live row
+  // for the user's medication set in ONE ordered `findMany`, group in
+  // memory by `medicationId`, and derive the per-med `lastIntakeAt` (max
+  // non-null takenAt) from the same grouped set the `findFirst` would
+  // have scanned. The grouping preserves the `scheduledFor asc` order the
+  // snap + heal passes depend on (a stable Postgres sort keeps the
+  // per-medication slices in the same order a per-med query returned).
+  const medIds = medications
+    .filter((m) => m.schedules.length > 0)
+    .map((m) => m.id);
 
-    // Latest non-tombstoned takenAt — only rolling schedules consult it,
-    // but the snap resolver needs it threaded in.
-    const lastIntake = await prisma.medicationIntakeEvent.findFirst({
-      where: {
-        userId,
-        medicationId: med.id,
-        deletedAt: null,
-        takenAt: { not: null },
-      },
-      orderBy: { takenAt: "desc" },
-      select: { takenAt: true },
-    });
-    const lastIntakeAt = lastIntake?.takenAt ?? null;
-
-    const rows = (await prisma.medicationIntakeEvent.findMany({
-      where: { userId, medicationId: med.id, deletedAt: null },
+  const rowsByMedication = new Map<string, DedupIntakeRow[]>();
+  const lastIntakeAtByMedication = new Map<string, Date | null>();
+  if (medIds.length > 0) {
+    const allRows = (await prisma.medicationIntakeEvent.findMany({
+      where: { userId, medicationId: { in: medIds }, deletedAt: null },
       select: {
         id: true,
         medicationId: true,
@@ -276,9 +275,37 @@ export async function dedupeUserIntakeSlots(
         // v1.16.10 — stamped losers refund their consumption on collapse.
         inventoryConsumption: true,
       },
-      orderBy: { scheduledFor: "asc" },
+      // `medicationId` first so the per-med slices are contiguous, then the
+      // `scheduledFor asc` the loop relies on.
+      orderBy: [{ medicationId: "asc" }, { scheduledFor: "asc" }],
     })) as DedupIntakeRow[];
 
+    for (const row of allRows) {
+      const list = rowsByMedication.get(row.medicationId);
+      if (list) {
+        list.push(row);
+      } else {
+        rowsByMedication.set(row.medicationId, [row]);
+      }
+      // Latest non-tombstoned takenAt per medication — the same value the
+      // per-med `findFirst({ takenAt: { not: null }, orderBy: desc })`
+      // returned. Only rolling schedules consult it, but the snap resolver
+      // needs it threaded in.
+      if (row.takenAt !== null) {
+        const prev = lastIntakeAtByMedication.get(row.medicationId) ?? null;
+        if (prev === null || row.takenAt.getTime() > prev.getTime()) {
+          lastIntakeAtByMedication.set(row.medicationId, row.takenAt);
+        }
+      }
+    }
+  }
+
+  for (const med of medications) {
+    if (med.schedules.length === 0) continue;
+
+    const lastIntakeAt = lastIntakeAtByMedication.get(med.id) ?? null;
+    const rows = rowsByMedication.get(med.id) ?? [];
+
     if (rows.length < 2) continue;
 
     // v1.16.9 — heal pass FIRST: converge ad-hoc actioned API/REMINDER