{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" DERFLADOOWRAG","gend":0,"add":"TOOF 2311NL SLLIH","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1945-08-29","age":"","mstatus":"","insh":"40604910697","cliId":"","pno":"9290503213","cno":"5092931230","email":"","ename":"","eno":"","pphy":"MICHAEL ABBOTT","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":"1336179928"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H52.03","H52.223","H52.4","E11.9","Z79.84","H25.13","I10","C61","N492","R32","Z191","G3184","E1169","E785","I129","E1122","N1831","E782","Z23","E119","R0781","M79605","S298XXA","W1839XA","H9190","Z0000","I700","E1149","E1159","I152","Z0101","H2513","H5203","H524","H52223","M109","N3941","Z8546","N4289","R197","R350","I2510","Z940","K5909","Z4889","S52022D","M25422","W1830XD","Z01818","Z967","Z09","D509","Z7984","Z87440","N3000","B954","N179","K520","N1830","S52022A","N400","R531","R296","W010XXA","G8918","Z98890","W19XXXA","N390","E876","I639","R9082","G9389","E860","R5381","A419","R6520","S0990XA","W1830XA","S79922A","R509","S3993XA","M7022","I252","Z7982","M25522","D120","D122","D125","D127","K5520","T8384XA","N402","N3040","R39198","Z923","K627","R300","K6289","Z1211","D123","E118","Z86010","K635","R310","N200","K760","N281","R911","Z01812","Z1159","N3001","M545","H9193","N49.2","Z19.1","G31.84","E11.69","E78.5","I12.9","E11.22","N18.31","E78.2","R07.81","M79.605","S29.8XXA","W18.39XA","H91.90","Z00.00","I70.0","E11.49","E11.59","I15.2","Z01.01","M10.9","N39.41","Z85.46","N42.89","R19.7","R35.0","I25.10","Z94.0","K59.09","Z48.89","S52.022D","M25.422","W18.30XD","Z01.818","Z96.7","D50.9","Z87.440","N30.00","B95.4","N17.9","K52.0","N18.30","S52.022A","N40.0","R53.1","R29.6","W01.0XXA","G89.18","Z98.890","W19.XXXA","N39.0","E87.6","I63.9","R90.82","G93.89","E86.0","R53.81","A41.9","R65.20","S09.90XA","W18.30XA","S79.922A","R50.9","S39.93XA","M70.22","I25.2","Z79.82","M25.522","D12.0","D12.2","D12.5","D12.7","K55.20","T83.84XA","N40.2","N30.40","R39.198","Z92.3","K62.7","R30.0","K62.89","Z12.11","D12.3","E11.8","Z86.010","K63.5","R31.0","N20.0","K76.0","N28.1","R91.1","Z01.812","Z11.59","N30.01","M54.5","H91.93"],"date":["2023-06-20","2023-06-20","2023-06-20","2023-06-20","2023-06-20","2023-06-20","2023-06-20","2022-12-30","2022-12-16","2022-12-30","2022-12-16","2022-10-17","2022-10-17","2022-10-17","2022-10-10","2022-10-10","2022-10-10","2022-10-04","2022-10-19","2022-09-27","2022-09-27","2022-09-16","2022-09-16","2022-09-16","2022-04-27","2022-03-30","2022-03-30","2022-03-30","2022-03-28","2022-03-28","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2022-03-23","2021-12-17","2021-12-17","2021-12-17","2021-10-05","2021-09-21","2021-09-07","2021-09-07","2021-09-01","2021-08-20","2021-08-18","2021-08-18","2021-08-18","2021-08-18","2021-08-03","2021-07-30","2021-08-13","2021-07-30","2021-07-26","2021-07-19","2021-07-13","2021-07-12","2021-07-13","2021-07-06","2021-07-13","2021-07-09","2021-07-13","2021-07-11","2021-07-11","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-09","2021-07-08","2021-07-07","2021-07-07","2021-07-07","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-02","2021-07-02","2021-07-02","2021-07-02","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-29","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2021-06-14","2021-06-03","2021-06-03","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-05-10","2021-01-25","2020-12-14","2020-12-14","2020-12-14","2020-12-14","2020-12-09","2020-11-12","2020-10-09","2020-08-27","2020-08-27","2022-12-30","2022-12-30","2022-11-07","2022-10-31","2023-03-31","2022-10-18","2022-10-18","2022-10-18","2022-10-19","2022-10-06","2022-10-04","2022-09-30","2022-09-30","2023-03-31","2022-04-07","2022-04-07","2022-04-07","2022-04-06","2022-04-06","2022-04-01","2022-04-06","2022-04-06","2022-04-06","2021-10-25","2021-10-01","2021-10-01","2022-08-30","2022-08-30","2021-10-01","2021-08-30","2021-08-30","2021-08-30","2021-08-30","2021-08-19","2021-08-13","2021-08-16","2021-08-25","2021-08-04","2021-08-04","2021-07-28","2021-07-19","2022-08-30","2021-07-26","2021-07-28","2021-08-04","2021-08-04","2021-07-26","2021-07-21","2021-07-22","2021-07-22","2021-07-28","2021-07-28","2021-07-23","2021-07-23","2021-07-23","2021-07-12","2021-07-12","2021-07-13","2021-07-13","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-21","2021-07-19","2021-07-19","2021-07-19","2021-07-12","2021-07-14","2021-07-14","2021-07-14","2021-07-14","2021-07-12","2021-07-06","2021-07-06","2021-07-06","2021-07-02","2021-07-02","2021-07-06","2021-06-10","2021-06-10","2021-05-19","2021-05-19","2021-05-19","2021-05-19","2021-05-17","2021-02-08","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2020-11-27","2020-10-26","2020-11-14","2020-11-14"],"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":[["","","ROSUVASTATIN CALCIUM","40.000MG","90","Select","Select",""],["","","GLIPIZIDE ER","5.000MG","90","Select","Select",""],["","","FREESTYLE LITE TEST STRIPS","0","100","Select","Select",""],["","","ALLOPURINOL","100.000MG","-42","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","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":""}]}]}