{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"ENNAEJENIEH ","gend":1,"add":"TNOM 215RD YERE","city":"EAST WENATCHEE","state":"WA","zip":98802,"dob":"1941-01-31","age":"","mstatus":"","insh":"50604910349","cliId":"","pno":"6790500503","cno":"5097630500","email":"","ename":"","eno":"","pphy":"KATHRYN EREN","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":"1629365598"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S29019D","R69","Z85828","Z9049","Z90710","Z9089","M546","M419","Z09","G8929","Z981","M8588","M4185","H00022","Z0000","M8580","J310","J45990","E041","M461","L900","H353131","G5132","Z1231","L570","L578","L821","N9089","N952","M25562","M25462","C44729","L989","K219","F341","M7989","G5139","Z9841","J45909","H43813","Z961","H52223","H524","M545","R29810","E042","Z803","S29.019D","Z85.828","Z90.49","Z90.710","Z90.89","M54.6","M41.9","G89.29","Z98.1","M85.88","M41.85","H00.022","Z00.00","M85.80","J31.0","J45.990","E04.1","M46.1","L90.0","H35.3131","G51.32","Z12.31","L57.0","L57.8","L82.1","N90.89","N95.2","M25.562","M25.462","C44.729","L98.9","K21.9","F34.1","M79.89","G51.39","Z98.41","J45.909","H43.813","Z96.1","H52.223","H52.4","M54.5","R29.810","E04.2","Z80.3"],"date":["2022-12-22","2022-11-30","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-09-14","2022-09-14","2022-09-11","2022-09-11","2022-09-11","2022-08-17","2022-08-12","2022-07-19","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-06-20","2022-05-24","2022-05-24","2022-04-28","2022-02-08","2022-01-05","2021-11-30","2021-11-30","2021-11-30","2021-07-22","2021-07-22","2021-06-09","2021-06-09","2021-06-02","2021-05-27","2021-05-27","2021-05-27","2021-04-14","2021-03-25","2021-03-25","2021-03-25","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2020-11-17","2020-11-11","2020-11-06","2020-07-20","2022-12-22","2022-10-14","2022-10-14","2022-10-14","2022-10-14","2022-09-14","2022-09-14","2022-09-11","2022-09-11","2022-08-17","2022-08-12","2022-07-19","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-06-20","2022-05-24","2022-05-24","2022-04-28","2022-02-08","2022-01-05","2021-11-30","2021-11-30","2021-11-30","2021-07-22","2021-07-22","2021-06-09","2021-06-09","2021-06-02","2021-05-27","2021-05-27","2021-05-27","2021-04-14","2021-03-25","2021-03-25","2021-03-25","2020-12-23","2020-12-23","2020-12-23","2020-12-23","2020-11-17","2020-11-11","2020-11-06","2020-07-20"],"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":[["","","VENTOLIN HFA","108.000MCG\/ACT","18","Select","Select",""],["","","PREVNAR 20","0","0","Select","Select",""],["","","ALBUTEROL SULFATE HFA","108.000MCG\/ACT","8","Select","Select",""],["","","IPRATROPIUM BROMIDE","0.00%","45","Select","Select",""],["","","FLUZONE HIGH-DOSE PF 2022-2023","0","1","Select","Select",""],["","","ERYTHROMYCIN","5.000MG\/GM","3","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":""}]}]}