{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" AICIRTAPREKAMTAH","gend":1,"add":"HMA 9011EVA TSRE","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1946-11-25","age":"","mstatus":"","insh":"31604910501","cliId":"","pno":"6690532872","cno":"5096627823","email":"","ename":"","eno":"","pphy":"MARY TIMIRAS","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"Grant","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":"1750313987"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.69","E66.9","Z23","E1169","C50412","R000","E669","Z1211","E662","Z6837","E7849","R0609","Z170","C50812","F319","H4042X1","B0232","H209","Z7984","E119","F3170","R9431","I2109","Z9012","F329","Z4889","Z780","E139","E1369","C50012","Z803","E6601","D0512","D360","E785","J45909","I509","Z01812","Z20822","N6325","Z4589","N6321","H4042X2","C50.412","R00.0","Z12.11","E66.2","Z68.37","E78.49","R06.09","Z17.0","C50.812","F31.9","H40.42X1","B02.32","H20.9","Z79.84","E11.9","F31.70","R94.31","I21.09","Z90.12","F32.9","Z48.89","Z78.0","E13.9","E13.69","C50.012","Z80.3","E66.01","D05.12","D36.0","E78.5","J45.909","I50.9","Z01.812","Z20.822","N63.25","Z45.89","N63.21","H40.42X2"],"date":["2023-04-20","2023-04-20","2022-10-29","2022-09-21","2022-09-21","2022-09-21","2022-09-21","2022-06-08","2022-02-15","2022-02-15","2022-02-15","2022-01-31","2022-01-31","2022-01-18","2022-01-12","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-08","2021-12-08","2021-12-08","2021-11-30","2021-11-30","2021-11-23","2021-11-23","2021-11-08","2021-10-22","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-15","2021-10-15","2021-09-16","2021-09-16","2021-09-08","2021-03-18","2022-09-21","2022-09-21","2022-06-08","2022-02-15","2022-02-15","2022-02-15","2022-01-31","2022-01-31","2022-01-18","2022-01-12","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-30","2021-12-08","2021-12-08","2021-12-08","2021-11-30","2021-11-30","2021-11-23","2021-11-23","2021-11-08","2021-10-22","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-18","2021-10-15","2021-10-15","2021-09-16","2021-09-16","2021-09-08","2021-03-18"],"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":[["","","VALACYCLOVIR HYDROCHLORIDE","500","90","Select","Select",""],["","","METOPROLOL SUCCINATE ER","25","90","Select","Select",""],["","","ROSUVASTATIN CALCIUM","5","-90","Select","Select",""],["","","ANASTROZOLE","1","30","Select","Select",""],["","","TRUEPLUS LANCETS 33G","0","100","Select","Select",""],["","","EASY TOUCH ALCOHOL PREP PADS\/MEDIUM","70.00%","100","Select","Select",""],["","","FREESTYLE LITE TEST STRIPS","0","100","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","500.000MG","180","Select","Select",""],["","","JANUVIA","100.000MG","90","Select","Select",""],["","","ALCOHOL PREPS","70.00%","100","Select","Select",""],["","","SURE COMFORT ALCOHOL PREP PADS","70.00%","-100","Select","Select",""],["","","BINAXNOW COVID-19 AG CARD HOME TEST","0","8","Select","Select",""],["","","PREDNISOLONE ACETATE","1.00%","5","Select","Select",""],["","","ALCOHOL SWABS","70.00%","100","Select","Select",""],["","","PIOGLITAZONE HYDROCHLORIDE","30.000MG","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":""}]}]}