{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"S TSENREEKLIWHC","gend":0,"add":"AM 023TS NI","city":"OROVILLE","state":"WA","zip":98844,"dob":"1944-09-12","age":"","mstatus":"","insh":"31604910603","cliId":"","pno":"7490552626","cno":"5094762625","email":"","ename":"","eno":"","pphy":"KARA BERGS","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"Okanogan","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":"1790041317"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R25.2","M54.9","R07.81","I10","I70.0","E78.2","G47.33","E78.5","I20.8","R73.03","R0789","R7303","S2242XA","W000XXA","Y9301","G4733","U071","R400","G4700","R0902","R0683","R931","R079","E785","I700","R600","E669","R0681","I498","N400","R7309","R5383","Z961","H524","I252","H35362","H43812","Z09","H25812","E1136","H25811","H25813","H52223","M545","G8929","Z0100","H538","S336XXA","E119","R109","Z7184","Z23","R9431","Z8249","I4510","N281","I4519","H2513","R07.89","S22.42XA","W00.0XXA","Y93.01","U07.1","R40.0","G47.00","R09.02","R06.83","R93.1","R07.9","R60.0","E66.9","R06.81","I49.8","N40.0","R73.09","R53.83","Z96.1","H52.4","I25.2","H35.362","H43.812","H25.812","E11.36","H25.811","H25.813","H52.223","M54.5","G89.29","Z01.00","H53.8","S33.6XXA","E11.9","R10.9","Z71.84","R94.31","Z82.49","I45.10","N28.1","I45.19","H25.13"],"date":["2023-06-06","2023-06-06","2023-06-06","2023-05-26","2023-05-26","2023-05-26","2023-05-21","2023-05-19","2023-05-19","2023-05-19","2022-12-30","2022-12-30","2022-12-24","2022-12-24","2022-12-24","2022-12-21","2022-10-07","2022-09-27","2022-09-27","2022-09-27","2022-09-19","2022-08-10","2022-08-10","2022-08-10","2022-06-24","2022-06-24","2022-06-14","2022-06-14","2022-06-02","2022-04-28","2022-04-28","2022-04-21","2022-02-21","2022-01-26","2022-01-26","2022-01-07","2022-01-07","2022-01-07","2021-12-30","2021-11-18","2021-11-18","2021-10-19","2021-10-19","2021-07-15","2021-07-15","2021-07-14","2021-07-14","2021-07-12","2021-07-12","2021-07-07","2021-05-05","2021-05-05","2021-02-04","2021-02-04","2021-02-03","2021-01-14","2021-01-08","2020-09-04","2022-12-30","2022-12-24","2022-12-24","2022-12-24","2022-10-07","2022-09-27","2022-09-27","2022-09-27","2022-09-19","2022-08-10","2022-08-10","2022-06-24","2022-06-14","2022-06-14","2022-06-02","2022-04-28","2022-04-28","2022-04-21","2022-02-21","2022-01-26","2022-01-26","2022-01-07","2022-01-07","2021-12-30","2021-11-18","2021-11-18","2021-10-19","2021-10-19","2021-07-15","2021-07-15","2021-07-14","2021-07-14","2021-07-12","2021-07-12","2021-07-07","2021-05-05","2021-02-04","2021-02-04","2021-02-03","2021-01-14","2021-01-08","2020-09-04"],"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":[["","","AMLODIPINE BESYLATE","10","34","Select","Select",""],["","","EZETIMIBE","10","90","Select","Select",""],["","","NIACIN ER","1000","120","Select","Select",""],["","","PREDNISONE","10.000MG","30","Select","Select",""],["","","TIZANIDINE HYDROCHLORIDE","4.000MG","-30","Select","Select",""],["","","ENALAPRIL MALEATE","20.000MG","120","Select","Select",""],["","","FENOFIBRATE","160.000MG","90","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.000MG","90","Select","Select",""],["","","FUROSEMIDE","20.000MG","90","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","0","20","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":""}]}]}