{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NYLORACRENRUT ","gend":1,"add":"N N 517EVA ELI","city":"EAST WENATCHEE","state":"WA","zip":98802,"dob":"1946-04-29","age":"","mstatus":"","insh":"22014910784","cliId":"","pno":"2490545011","cno":"5094211054","email":"","ename":"","eno":"","pphy":"TYLER SHERMAN","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":"1386911626"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G40.909","M16.12","F01.50","R26.81","R29.898","Z91.81","I444","R410","R9431","G40909","M19011","G8929","I10","Z7409","M25511","Z993","F0150","L989","M810","G9340","M542","G465","E039","Z9119","L03115","R059","E079","I674","F329","G319","R569","Z87891","R4182","R55","R262","R292","G9520","R000","F0390","M19012","M2578","M5382","I517","G3189","M546","M25512","G4733","R4020","I6381","E6601","E876","G301","G9341","K5641","K5900","R1030","R519","R9082","Z8673","N390","R300","M25551","I639","R4701","R4781","R5381","R29818","G9389","R479","G311","I6782","R05","I491","I493","R0602","R51","R4789","I44.4","R41.0","R94.31","M19.011","G89.29","Z74.09","M25.511","Z99.3","L98.9","M81.0","G93.40","M54.2","G46.5","E03.9","Z91.19","L03.115","R05.9","E07.9","I67.4","F32.9","G31.9","R56.9","Z87.891","R41.82","R26.2","R29.2","G95.20","R00.0","F03.90","M19.012","M25.78","M53.82","I51.7","G31.89","M54.6","M25.512","G47.33","R40.20","I63.81","E66.01","E87.6","G30.1","G93.41","K56.41","01","K59.00","R10.30","R51.9","R90.82","Z86.73","N39.0","R30.0","M25.551","I63.9","R47.01","R47.81","R53.81","R29.818","G93.89","R47.9","G31.1","I67.82","I49.1","I49.3","R06.02","R47.89"],"date":["2023-06-15","2023-05-22","2023-05-22","2023-05-22","2023-05-22","2023-05-22","2022-11-10","2022-11-10","2022-11-10","2022-11-09","2022-10-23","2022-10-23","2022-10-23","2022-10-23","2022-09-13","2022-09-13","2022-04-19","2022-04-19","2022-03-14","2022-03-10","2022-03-10","2022-03-10","2022-03-01","2022-03-01","2021-11-26","2021-11-26","2021-11-26","2021-11-26","2021-11-26","2021-11-16","2021-11-13","2021-11-13","2021-11-13","2021-11-13","2021-10-06","2021-10-06","2021-10-06","2021-09-10","2021-09-09","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-08-18","2021-08-12","2021-08-09","2021-08-05","2021-08-08","2021-08-07","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-02-09","2020-10-13","2020-10-06","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-09-20","2020-09-20","2020-09-18","2020-09-18","2020-09-18","2022-11-10","2022-11-10","2022-11-10","2022-10-23","2022-10-23","2022-10-23","2022-09-13","2022-09-13","2022-04-19","2022-03-14","2022-03-10","2022-03-10","2022-03-10","2022-03-01","2022-03-01","2021-11-26","2021-11-26","2021-11-26","2021-11-26","2021-11-26","2021-11-16","2021-11-13","2021-11-13","2021-11-13","2021-10-06","2021-10-06","2021-10-06","2021-09-10","2021-09-09","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-09-08","2021-08-18","2021-08-12","2021-08-09","2021-08-05","2021-08-05","2021-08-08","2021-08-07","2021-08-05","2021-08-05","2021-08-05","2021-08-05","2021-02-09","2020-10-13","2020-10-06","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-10-05","2020-09-20","2020-09-20","2020-09-18","2020-09-18"],"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":[["","","POTASSIUM CHLORIDE ER","10","180","Select","Select",""],["","","OXCARBAZEPINE","600","60","Select","Select",""],["","","LOSARTAN POTASSIUM","100","90","Select","Select",""],["","","ZONISAMIDE","100.000MG","54","Select","Select",""],["","","AMLODIPINE BESYLATE","10.000MG","90","Select","Select",""],["","","LEVOTHYROXINE SODIUM","125.000MCG","90","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":""}]}]}