{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"R PILIHPNESSUMSA","gend":0,"add":"PA 5914RD LIR","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1944-12-06","age":"","mstatus":"","insh":"16904910261","cliId":"","pno":"6690533597","cno":"5096679533","email":"","ename":"","eno":"","pphy":"PETR SLAPNICKA","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"Chelan","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":"1073532172"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z79.899","M46.1","I10","I48.0","M25.552","M79.605","G60.9","G56.03","H40.003","H21.89","H25.13","H35.033","H35.363","M53.3","G89.29","M47.816","M79.661","Z86.718","Z79899","M1A0710","Z0001","E790","Z4889","G5602","G609","G5603","G4733","H04123","I480","I471","R001","G5622","Z0101","H40003","H2513","R200","L570","Z85828","L821","L814","R69","L03031","L02611","M25552","M79605","L600","B351","J45909","Z86718","I2602","M79674","M545","M47816","G4730","R0683","G47419","J45991","M25561","M79604","M79606","M79661","M79662","M7989","E785","R202","R739","Z471","Z96651","H2189","H52203","H524","Z7901","Z5181","M1711","E781","Z86711","G8918","K219","Z20822","Z119","L918","L538","Z01812","I739","R42","M25571","N401","N529","Z20828","R9720","N5201","S86011A","R61","R0602","I4891","I2692","I951","J9601","N179","R7989","E876","Z98890","J9811","I2699","R531","R55","I249","S93491A","M25471","R937","S86019A","S93431A","X509XXA","M7661","R936","M1A.0710","Z00.01","E79.0","Z48.89","G56.02","G47.33","H04.123","I47.1","R00.1","G56.22","Z01.01","R20.0","L57.0","Z85.828","L82.1","L81.4","L03.031","L02.611","L60.0","B35.1","J45.909","I26.02","M79.674","M54.5","G47.30","R06.83","G47.419","J45.991","M25.561","M79.604","M79.606","M79.662","M79.89","E78.5","R20.2","R73.9","Z47.1","Z96.651","H52.203","H52.4","Z79.01","Z51.81","M17.11","E78.1","Z86.711","G89.18","K21.9","Z20.822","Z11.9","L91.8","L53.8","Z01.812","I73.9","M25.571","N40.1","N52.9","Z20.828","R97.20","N52.01","S86.011A","R06.02","I48.91","I26.92","I95.1","J96.01","N17.9","R79.89","E87.6","Z98.890","J98.11","I26.99","R53.1","I24.9","S93.491A","M25.471","R93.7","S86.019A","S93.431A","X50.9XXA","M76.61","R93.6"],"date":["2023-06-20","2023-06-20","2023-06-20","2023-06-20","2023-06-13","2023-06-13","2023-05-30","2023-05-30","2023-05-30","2023-05-30","2023-05-30","2023-05-30","2023-05-30","2023-05-08","2023-05-08","2023-05-08","2023-04-14","2023-04-14","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-12-15","2022-12-02","2022-11-11","2022-11-11","2022-10-13","2022-10-13","2022-10-13","2022-10-13","2022-09-15","2022-07-12","2022-05-26","2022-05-26","2022-05-26","2022-03-31","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2022-03-09","2021-12-06","2021-11-10","2021-11-03","2021-11-03","2021-10-22","2021-10-22","2021-10-22","2021-10-07","2021-10-07","2021-09-30","2021-09-30","2021-09-30","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-07-27","2021-07-27","2021-07-03","2021-07-03","2021-07-03","2021-07-03","2021-07-01","2021-06-22","2021-06-22","2021-06-08","2021-06-08","2021-05-24","2021-05-24","2021-05-24","2021-04-05","2021-04-05","2021-03-30","2021-03-30","2021-03-29","2021-03-29","2021-03-29","2021-03-27","2021-03-27","2021-03-18","2021-03-18","2021-03-02","2021-03-02","2021-01-27","2021-01-12","2020-12-22","2020-12-22","2020-11-20","2020-11-13","2020-11-12","2020-10-27","2020-10-14","2020-10-14","2020-10-14","2020-09-30","2020-09-25","2020-09-21","2020-09-19","2020-09-19","2020-09-20","2020-09-19","2020-09-21","2020-09-20","2020-09-19","2020-09-19","2020-09-19","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-06","2020-08-06","2022-12-20","2022-12-20","2022-12-20","2022-12-15","2022-12-02","2022-10-13","2022-10-13","2022-10-13","2022-09-15","2022-07-12","2022-05-26","2022-03-31","2022-03-24","2022-03-24","2022-03-24","2022-03-24","2021-12-06","2021-11-10","2021-10-22","2021-10-22","2021-10-22","2021-10-07","2021-09-30","2021-09-30","2021-09-13","2021-09-13","2021-09-13","2021-09-13","2021-07-27","2021-07-27","2021-07-03","2021-07-03","2021-07-03","2021-07-01","2021-06-22","2021-06-22","2021-06-08","2021-06-08","2021-05-24","2021-05-24","2021-04-05","2021-04-05","2021-03-30","2021-03-30","2021-03-29","2021-03-29","2021-03-29","2021-03-27","2021-03-27","2021-03-18","2021-03-18","2021-03-02","2021-03-02","2021-01-12","2020-12-22","2020-12-22","2020-11-20","2020-11-13","2020-11-12","2020-10-27","2020-10-14","2020-10-14","2020-09-30","2020-09-25","2020-09-21","2020-09-19","2020-09-19","2020-09-20","2020-09-19","2020-09-21","2020-09-20","2020-09-19","2020-09-19","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-21","2020-08-06","2020-08-06"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}}]},{"t":"Covid Screening","q":[{"a":[]}]},{"t":"Self-Assessment and Social History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[]}]},{"t":"Medical History","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Family History","q":[{"a":[]}]},{"t":"Preventive Care","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","SHINGRIX","50.000MCG\/0.5ML","1","Select","Select",""],["","","BOOSTRIX","0","0","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.000MG","90","Select","Select",""],["","","SPIRONOLACTONE\/HYDROCHLOROTHIAZIDE","0","90","Select","Select",""],["","","METOPROLOL SUCCINATE ER","50.000MG","45","Select","Select",""],["","","LOSARTAN POTASSIUM","100.000MG","90","Select","Select",""],["","","ALLOPURINOL","100.000MG","90","Select","Select",""],["","","GAVILYTE-C","0","4000","Select","Select",""],["","","MELOXICAM","7.000MG","30","Select","Select",""],["","","METHOCARBAMOL","750.000MG","21","Select","Select",""],["","","FLUZONE HIGH-DOSE PF 2022-2023","0","1","Select","Select",""],["","","MODERNA COVID-19 VACCINE\/BIVALENT\/BA.4\/BA.5","50.000MCG\/0.5ML","1","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Review of Systems and Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"","a10":[],"a11":"","a12":"","a13":""}]}]}