{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ECNERALCNOSAUT ","gend":0,"add":"AC WN 0432EVA EDACS","city":"EAST WENATCHEE","state":"WA","zip":98802,"dob":"1934-09-29","age":"","mstatus":"","insh":"48704910731","cliId":"","pno":"8890554704","cno":"5098840745","email":"","ename":"","eno":"","pphy":"ANTON ZAVOYSKIKH","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":"1033640636"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H40.003","H35.313","I12.9","N18.31","M79.89","R71.8","I10","R252","M9901","M5412","M9902","M5414","H40003","I739","I6523","I70213","Z7901","M48062","M549","M4316","M5186","M47816","M5126","I129","N1831","M5459","M48061","I480","I209","R69","Z0000","M160","J432","Z1152","Z01818","Z23","G4733","G4736","G479","E119","I2510","I4891","M5442","G8929","E785","Z4802","M5136","L531","L853","C44629","H26492","H4010X0","R911","Z20822","L989","I25119","G4730","G47419","E7800","Z87891","Z5181","H53451","H35361","R944","Z79899","D649","D500","I110","I70219","J449","R25.2","M99.01","M54.12","M99.02","M54.14","I73.9","I65.23","I70.213","Z79.01","M48.062","M54.9","M43.16","M51.86","M47.816","M51.26","M54.59","M48.061","I48.0","I20.9","Z00.00","M16.0","J43.2","Z11.52","Z01.818","G47.33","G47.36","G47.9","E11.9","I25.10","I48.91","M54.42","G89.29","E78.5","Z48.02","M51.36","L53.1","L85.3","C44.629","H26.492","H40.10X0","R91.1","Z20.822","L98.9","I25.119","G47.30","G47.419","E78.00","Z87.891","Z51.81","H53.451","H35.361","R94.4","Z79.899","D64.9","D50.0","I11.0","I70.219","J44.9"],"date":["2023-06-12","2023-06-12","2023-05-17","2023-05-17","2023-05-17","2023-05-17","2022-12-29","2022-12-29","2022-12-27","2022-12-27","2022-12-27","2022-12-27","2022-12-12","2022-12-02","2022-12-02","2022-12-02","2022-11-30","2022-11-28","2022-11-16","2022-11-16","2022-11-16","2022-11-16","2022-10-31","2022-09-08","2022-09-08","2022-08-29","2022-08-29","2022-08-26","2022-08-26","2022-05-31","2022-05-27","2022-05-17","2022-05-05","2022-05-04","2022-05-04","2022-04-23","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-20","2022-04-20","2022-04-20","2022-04-13","2022-04-11","2022-04-01","2022-04-01","2022-04-01","2022-03-31","2022-03-31","2022-03-21","2022-03-17","2022-03-03","2022-03-03","2022-02-11","2022-02-11","2021-09-02","2021-08-20","2021-01-26","2020-12-22","2020-12-22","2020-11-22","2020-11-19","2020-10-20","2020-08-05","2020-03-06","2020-03-06","2020-03-06","2022-12-29","2022-12-27","2022-12-27","2022-12-27","2022-12-27","2022-12-02","2022-12-02","2022-12-02","2022-11-30","2022-11-28","2022-11-16","2022-11-16","2022-11-16","2022-11-16","2022-10-31","2022-08-29","2022-08-29","2022-08-26","2022-08-26","2022-05-27","2022-05-17","2022-05-05","2022-05-04","2022-05-04","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-22","2022-04-20","2022-04-20","2022-04-20","2022-04-13","2022-04-11","2022-04-01","2022-04-01","2022-04-01","2022-03-31","2022-03-31","2022-03-21","2022-03-17","2022-03-03","2022-03-03","2022-02-11","2022-02-11","2021-09-02","2021-08-20","2021-01-26","2020-12-22","2020-12-22","2020-11-22","2020-11-19","2020-10-20","2020-08-05","2020-03-06","2020-03-06","2020-03-06"],"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":[["","","PRAVASTATIN SODIUM","80","90","Select","Select",""],["","","ELIQUIS","5.000MG","180","Select","Select",""],["","","BUMETANIDE","1.000MG","90","Select","Select",""],["","","TELMISARTAN","40.000MG","90","Select","Select",""],["","","OMEPRAZOLE","20.000MG","90","Select","Select",""],["","","LATANOPROST","0.00%","7","Select","Select",""],["","","ALBUTEROL SULFATE HFA","108.000MCG\/ACT","8","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12.000MG","90","Select","Select",""],["","","SHINGRIX","50.000MCG\/0.5ML","1","Select","Select",""],["","","SPIRONOLACTONE","25.000MG","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":""}]}]}