{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"SOC ARUALED SELAT","gend":1,"add":"GOD 314NL DOOW","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1929-06-20","age":"","mstatus":"","insh":"30014910614","cliId":"","pno":"3490542013","cno":"5094331024","email":"","ename":"","eno":"","pphy":"JASON SHATTUCK","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":"1255541371"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","E78.00","F03.90","F32.1","I44.2","E7800","L84","M79671","B351","M2041","M79672","Z0000","M810","F0390","Z45018","I442","L909","F0280","G9389","R9082","Z8673","G3189","I5032","F321","I2510","Z950","E785","G309","I110","Z5189","I5031","S0093XA","I498","I493","I441","R9431","I444","R55","R001","S0990XA","I447","Z20822","S098XXA","W01198A","S298XXA","N3281","R351","F5101","R040","R0602","M545","G8929","H353132","Z961","H0100A","H52223","M48062","M25552","M25551","Z23","S73191A","X58XXXA","R935","M778","M79604","S43431A","M79.671","B35.1","M20.41","M79.672","Z00.00","M81.0","Z45.018","L90.9","F02.80","G93.89","R90.82","Z86.73","G31.89","I50.32","I25.10","Z95.0","E78.5","G30.9","I11.0","Z51.89","I50.31","S00.93XA","I49.8","I49.3","I44.1","R94.31","I44.4","R00.1","S09.90XA","I44.7","Z20.822","S09.8XXA","W01.198A","S29.8XXA","N32.81","R35.1","F51.01","R04.0","R06.02","M54.5","G89.29","H35.3132","Z96.1","H01.00A","H52.223","M48.062","M25.552","M25.551","S73.191A","X58.XXXA","R93.5","M77.8","M79.604","S43.431A"],"date":["2023-06-12","2023-06-12","2023-06-12","2023-06-12","2023-06-12","2022-12-22","2022-12-12","2022-12-06","2022-12-06","2022-12-06","2022-12-06","2022-11-21","2022-11-21","2022-11-14","2022-09-20","2022-09-20","2022-08-04","2022-05-18","2022-04-27","2022-04-27","2022-04-27","2022-04-27","2022-01-11","2022-01-11","2022-01-11","2021-12-21","2021-12-21","2021-12-21","2021-12-21","2021-12-20","2021-12-17","2021-12-10","2021-12-14","2021-12-14","2021-12-13","2021-12-13","2021-12-13","2022-01-03","2021-12-11","2021-12-10","2021-12-10","2021-12-10","2021-12-10","2021-12-10","2021-12-10","2021-11-19","2021-08-09","2021-07-08","2021-06-04","2021-06-04","2021-04-05","2021-04-05","2021-03-23","2021-03-23","2021-03-23","2021-03-23","2020-12-01","2020-10-20","2020-10-20","2020-11-02","2020-09-23","2020-09-23","2020-09-23","2020-09-23","2020-09-23","2020-09-23","2022-12-12","2022-12-12","2022-12-12","2022-12-08","2022-12-01","2022-12-01","2022-09-26","2022-08-11","2022-05-31","2022-05-03","2022-05-12","2022-05-03","2022-05-12","2022-08-11","2022-08-11","2022-02-02","2022-08-11","2022-08-11","2022-08-11","2021-12-27","2022-01-03","2022-01-31","2021-12-20","2021-12-20","2021-12-15","2021-12-20","2021-12-20","2022-01-03","2021-12-20","2021-12-15","2021-12-20","2022-01-03","2022-01-07","2022-01-07","2021-11-24","2021-08-20","2021-07-27","2021-06-18","2021-06-18","2021-04-14","2021-04-14","2021-04-01","2021-04-01","2021-04-01","2021-04-01","2021-01-06","2020-11-02","2020-11-02","2020-10-01","2020-10-01","2020-09-30","2020-09-30","2020-09-30","2020-09-30"],"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":[["","","DONEPEZIL HYDROCHLORIDE","5","30","Select","Select",""],["","","PRAVASTATIN SODIUM","40.000MG","90","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25.000MG","90","Select","Select",""],["","","IRBESARTAN","150.000MG","90","Select","Select",""],["","","FLOWFLEX COVID-19 ANTIGEN HOME TEST","0","8","Select","Select",""],["","","DICLOFENAC SODIUM","1.00%","100","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","0.00%","10","Select","Select",""],["","","NITROGLYCERIN","0.000MG","25","Select","Select",""],["","","CICLOPIROX NAIL LACQUER","8.00%","6","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50.000MG","30","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":""}]}]}