{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" EIMMIJREPOOC","gend":0,"add":"IH NALEHC 35DR SERCA SLL","city":"ORONDO","state":"WA","zip":98843,"dob":"1945-03-10","age":"","mstatus":"","insh":"60604910714","cliId":"","pno":"8690535137","cno":"5096873153","email":"","ename":"","eno":"","pphy":"TOBE HARBERD","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":"1629158019"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I739","R200","M25551","M25552","M170","G629","Z6837","R739","G4733","I6523","N189","Z23","I6522","I25119","J438","I10","R040","N400","F5221","R400","F419","E785","R413","I2510","J449","E875","N289","I73.9","R20.0","M25.551","M25.552","M17.0","G62.9","Z68.37","R73.9","G47.33","I65.23","N18.9","I65.22","I25.119","J43.8","R04.0","N40.0","F52.21","R40.0","F41.9","E78.5","R41.3","I25.10","J44.9","E87.5","N28.9"],"date":["2022-12-22","2022-12-22","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-06","2022-10-24","2022-10-18","2022-10-14","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-06-10","2022-06-02","2022-06-02","2022-04-14","2022-02-22","2022-02-22","2022-02-22","2021-09-28","2021-05-05","2021-03-22","2021-02-17","2022-12-22","2022-12-22","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-19","2022-12-06","2022-10-24","2022-10-18","2022-10-12","2022-10-12","2022-10-12","2022-06-10","2022-06-02","2022-06-02","2022-04-14","2022-02-22","2022-02-22","2022-02-22","2021-09-28","2021-05-05","2021-03-22","2021-02-17"],"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":[["","","SIMVASTATIN","40","90","Select","Select",""],["","","METOPROLOL TARTRATE","25","180","Select","Select",""],["","","QVAR REDIHALER","80","-10","Select","Select",""],["","","CHLORDIAZEPOXIDE HCL","10","60","Select","Select",""],["","","VENTOLIN HFA","108","18","Select","Select",""],["","","FINASTERIDE","5","90","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","0","360","Select","Select",""],["","","BUSPIRONE HCL","30","180","Select","Select",""],["","","AMLODIPINE BESYLATE","5.000MG","90","Select","Select",""],["","","MIRTAZAPINE","45.000MG","90","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","0.000MG","90","Select","Select",""],["","","SYMBICORT","0","10","Select","Select",""],["","","BUDESONIDE\/FORMOTEROL FUMARATE DIHYDRATE","0","-10","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","30.000MG","180","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":""}]}]}