{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" ADNILNESNAH","gend":1,"add":"LAG 0221TS SREL","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1944-09-23","age":"","mstatus":"","insh":"56904910314","cliId":"","pno":"6690577429","cno":"5096692477","email":"","ename":"","eno":"","pphy":"MARY RIDGEWAY","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":"1477585875"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z12.31","R01.1","E11.22","I12.9","N18.32","F33.0","Z79.4","G31.84","E78.00","M70.62","E66.09","Z68.36","E11.9","M70.61","M16.0","L570","Z85828","L578","L821","E1122","N1832","Z794","E1165","F330","G3184","I10","R251","R42","Z818","M7061","I129","E7800","N3000","E11649","R001","I4581","R5383","E6601","H52223","H524","Z09","C44519","L0889","L814","B079","H25811","E1136","Z0001","Z1159","N1830","T783XXA","N898","Z79899","T464X5A","N1831","Z23","H25812","K219","E785","H25813","J188","B370","B373","E119","M069","R05","R0602","Z20822","J189","G319","R791","J690","I77810","R948","R0600","J479","I2510","I517","H903","H6123","Z0000","F329","J387","Z6841","Z1231","Z803","J060","J40","J069","L57.0","Z85.828","L57.8","L82.1","E11.65","R25.1","Z81.8","N30.00","E11.649","R00.1","I45.81","R53.83","E66.01","H52.223","H52.4","C44.519","L08.89","L81.4","B07.9","H25.811","E11.36","Z00.01","Z11.59","N18.30","T78.3XXA","N89.8","Z79.899","T46.4X5A","N18.31","H25.812","K21.9","E78.5","H25.813","J18.8","B37.0","B37.3","M06.9","R06.02","Z20.822","J18.9","G31.9","R79.1","J69.0","I77.810","R94.8","R06.00","J47.9","I25.10","I51.7","H90.3","H61.23","Z00.00","F32.9","J38.7","Z68.41","Z80.3","J06.0","J06.9"],"date":["2023-06-05","2023-06-02","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-25","2023-05-24","2023-05-23","2023-05-23","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-12-09","2022-12-09","2022-12-09","2022-12-09","2022-12-09","2022-12-09","2022-12-09","2022-11-29","2022-11-29","2022-11-29","2022-10-12","2022-10-04","2022-10-04","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-08-29","2022-06-22","2022-06-22","2022-06-22","2022-06-21","2022-06-21","2022-06-16","2022-06-16","2022-05-25","2022-05-25","2022-05-23","2022-05-17","2022-05-17","2022-05-15","2022-05-15","2022-05-15","2022-05-15","2022-05-10","2021-12-16","2021-12-15","2021-12-15","2021-12-15","2021-10-05","2021-08-24","2021-07-05","2021-07-05","2021-07-05","2021-07-05","2021-07-02","2021-07-02","2021-07-02","2021-07-01","2021-06-30","2021-06-28","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-04-30","2021-04-14","2020-10-16","2020-10-16","2020-09-24","2020-09-17","2020-07-09","2020-07-09","2020-02-07","2020-02-07","2020-02-07","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-12-09","2022-11-29","2022-11-29","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-09-30","2022-08-29","2022-06-22","2022-06-22","2022-06-21","2022-06-21","2022-06-16","2022-06-16","2022-05-25","2022-05-25","2022-05-23","2022-05-17","2022-05-17","2022-05-15","2022-05-15","2022-05-15","2022-05-15","2022-05-10","2021-12-15","2021-12-15","2021-12-15","2021-10-05","2021-08-24","2021-07-05","2021-07-05","2021-07-05","2021-07-02","2021-07-02","2021-07-01","2021-06-30","2021-06-28","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-06-26","2021-04-30","2021-04-14","2020-10-16","2020-10-16","2020-09-24","2020-09-17","2020-07-09","2020-02-07","2020-02-07"],"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":[["","","BD PEN NEEDLE\/NANO\/ULTRA -FINE\/32G X 4MM","0","100","Select","Select",""],["","","AMLODIPINE BESYLATE","5.000MG","90","Select","Select",""],["","","PRAVASTATIN SODIUM","40.000MG","90","Select","Select",""],["","","CITALOPRAM HYDROBROMIDE","20.000MG","90","Select","Select",""],["","","DONEPEZIL HYDROCHLORIDE","5.000MG","90","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","1000.000MG","180","Select","Select",""],["","","SPIRONOLACTONE","25.000MG","180","Select","Select",""],["","","AMOXICILLIN","500.000MG","21","Select","Select",""],["","","BD PEN NEEDLE\/NANO 2ND GEN\/32G X 5\/32\"","0","-90","Select","Select",""],["","","LEVEMIR FLEXPEN","100.000UNIT\/ML","30","Select","Select",""],["","","LEVEMIR FLEXTOUCH","100.000UNIT\/ML","-30","Select","Select",""],["","","FLUOXETINE HYDROCHLORIDE","20.000MG","270","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","0","14","Select","Select",""],["","","DICLOFENAC SODIUM","1.00%","100","Select","Select",""],["","","METHYLPREDNISOLONE DOSE PACK","4.000MG","21","Select","Select",""],["","","SHINGRIX","50.000MCG\/0.5ML","1","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4.000MG","30","Select","Select",""],["","","MECLIZINE HYDROCHLORIDE","25.000MG","30","Select","Select",""],["","","FREESTYLE LITE TEST STRIPS","0","200","Select","Select",""],["","","CEPHALEXIN","500.000MG","21","Select","Select",""],["","","BOOSTRIX","0","1","Select","Select",""],["","","VICTOZA","18.000MG\/3ML","6","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":""}]}]}