{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"NASUSKRID ","gend":1,"add":"REGDAB 48641DR NIATNUOM ","city":"EAST WENATCHEE","state":"WA","zip":98802,"dob":"1946-05-27","age":"","mstatus":"","insh":"50604910869","cliId":"","pno":"8890516256","cno":"5098865261","email":"","ename":"","eno":"","pphy":"RUSSELL HAVLICEK","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":"1861423741"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D520","D513","F1010","E785","F1020","F17210","I10","S82832D","G20","R627","F10920","S82425A","Z720","M80062D","R296","M6281","R2681","B967","D519","A0472","M810","E7800","R259","M80062A","N3090","B9620","G119","E538","E871","R531","E8770","J90","R918","I491","E8342","I493","R9431","S82832A","D649","G9389","W19XXXA","R079","Z20822","S82435A","R2242","J432","E041","J439","Z09","A4151","N3000","D539","R6520","Z66","E876","A419","D720","I4589","N390","R42","R55","W1830XA","I6782","Z9181","M818","Z1211","D509","R739","D52.0","D51.3","F10.10","E78.5","F10.20","F17.210","S82.832D","R62.7","F10.920","S82.425A","Z72.0","M80.062D","R29.6","M62.81","R26.81","B96.7","D51.9","A04.72","M81.0","E78.00","R25.9","M80.062A","N30.90","B96.20","G11.9","E53.8","E87.1","R53.1","E87.70","R91.8","I49.1","E83.42","I49.3","R94.31","S82.832A","D64.9","G93.89","W19.XXXA","R07.9","Z20.822","S82.435A","R22.42","J43.2","E04.1","J43.9","A41.51","N30.00","D53.9","R65.20","E87.6","A41.9","D72.0","I45.89","N39.0","W18.30XA","I67.82","Z91.81","M81.8","Z12.11","D50.9","R73.9"],"date":["2022-08-23","2022-08-23","2022-08-23","2022-08-15","2022-08-15","2022-08-15","2022-10-12","2022-08-10","2022-09-15","2022-08-10","2022-07-26","2022-07-26","2022-07-26","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-07-01","2022-06-28","2022-06-28","2022-06-22","2022-06-17","2022-06-24","2022-06-21","2022-06-28","2022-06-22","2022-07-14","2022-06-22","2022-06-20","2022-06-20","2022-06-18","2022-06-18","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-06-17","2022-07-14","2022-06-13","2022-06-16","2022-06-14","2022-06-16","2022-06-24","2022-06-13","2022-06-16","2022-06-15","2022-06-14","2022-06-14","2022-07-01","2022-07-01","2022-06-13","2022-06-13","2022-06-13","2021-04-21","2021-03-17","2021-02-27","2021-02-27","2022-09-15","2022-09-15","2022-09-15","2022-10-12","2022-10-12","2022-10-12","2022-09-15","2022-09-15","2022-08-04","2022-08-04","2022-08-04","2022-08-05","2022-08-05","2022-08-05","2022-08-05","2022-08-05","2022-08-05","2022-07-28","2022-07-14","2022-07-14","2022-07-14","2022-07-28","2022-07-28","2022-07-28","2022-07-08","2022-07-28","2022-07-28","2022-07-28","2022-06-29","2022-07-14","2022-06-24","2022-07-28","2022-06-24","2022-06-24","2022-06-24","2022-07-18","2022-07-20","2022-07-20","2022-07-06","2022-07-06","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-06-24","2022-07-18","2022-07-19","2022-07-18","2022-06-24","2022-07-19","2022-06-27","2022-06-23","2022-07-19","2022-07-01","2022-07-06","2022-07-06","2021-04-26","2021-03-29","2021-03-09","2021-03-09"],"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":[["","","CARBIDOPA\/LEVODOPA","0","270","Select","Select",""],["","","METOPROLOL SUCCINATE ER","50","90","Select","Select",""],["","","SPIRONOLACTONE","50","90","Select","Select",""],["","","ATORVASTATIN CALCIUM","10","90","Select","Select",""],["","","ALENDRONATE SODIUM","70.000MG","12","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":""}]}]}