{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J LORACNOSSNO","gend":1,"add":"OSLEN E 1041501 TPA DR N","city":"MOSES LAKE","state":"WA","zip":98837,"dob":"1951-06-18","age":"","mstatus":"","insh":"24014910567","cliId":"","pno":"3294940120","cno":"9492302104","email":"","ename":"","eno":"","pphy":"BETH BLANKENSHIP","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"Douglas","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":"1437240181"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z7901","I480","R69","I471","L570","L821","Z85828","R252","I495","R110","I472","T462X5A","Z20822","I517","R55","I498","I4519","I4891","Z48812","M6281","R42","G459","R001","R5381","R9431","R000","I959","E785","I081","R251","Z85820","I491","I4581","R0789","I7090","R9089","R918","R29818","R9082","I6521","R2681","R531","R519","R6889","R61","G43909","R197","Z79.01","I48.0","I47.1","L57.0","L82.1","Z85.828","R25.2","I49.5","R11.0","I47.2","T46.2X5A","Z20.822","I51.7","I49.8","I45.19","I48.91","Z48.812","M62.81","G45.9","R00.1","R53.81","R94.31","R00.0","I95.9","E78.5","I08.1","R25.1","Z85.820","I49.1","I45.81","R07.89","I70.90","R90.89","R91.8","R29.818","R90.82","I65.21","R26.81","R53.1","R51.9","R68.89","G43.909","R19.7"],"date":["2022-08-10","2022-08-10","2022-06-16","2021-12-22","2021-11-11","2021-11-11","2021-11-11","2021-10-07","2021-10-07","2021-10-07","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-09-29","2021-09-29","2021-09-29","2021-09-28","2021-09-27","2021-09-24","2021-09-24","2021-09-22","2021-09-18","2021-09-15","2021-09-18","2021-09-23","2021-09-22","2021-09-20","2021-09-19","2021-09-18","2021-09-18","2021-09-16","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-04-13","2021-04-13","2021-04-13","2021-04-13","2020-08-15","2022-08-10","2022-08-10","2021-12-22","2021-11-11","2021-11-11","2021-11-11","2021-10-07","2021-10-07","2021-10-07","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-10-01","2021-09-29","2021-09-29","2021-09-28","2021-09-27","2021-09-24","2021-09-24","2021-09-22","2021-09-18","2021-09-15","2021-09-18","2021-09-23","2021-09-22","2021-09-20","2021-09-19","2021-09-18","2021-09-18","2021-09-16","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-09-15","2021-04-13","2021-04-13","2021-04-13","2020-08-15"],"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":[["","","ELIQUIS","5","60","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":""}]}]}