{"version":"0.4","data":[{"t":"Demographics","q":[{"name":" YHTACNADREB","gend":1,"add":"NAH 1061YAW HAN","city":"EAST WENATCHEE","state":"WA","zip":98802,"dob":"1950-07-31","age":"","mstatus":"","insh":"67014910736","cliId":"","pno":"8890505876","cno":"5098867850","email":"","ename":"","eno":"","pphy":"CASEY WYATT","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"Grant","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":"1134403678"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F33.42","F41.9","B37.9","E78.5","Z01.30","E03.9","R53.83","Z12.11","T63.481","B00.9","R69","H8113","E559","F331","E039","M797","F32A","F419","H269","E785","F329","L0100","R5383","R5382","Z7689","E02","J302","G933","H353132","H40013","H2513","H43813","H5213","H52203","Z8616","Z8701","Z7901","I82542","R0602","R0609","U099","R0902","I82442","E079","G43909","R300","N3000","U071","I82409","A4189","J9601","J1282","E876","F418","F429","I82402","A419","M79671","A09","E860","R55","Z20828","R4020","R001","B349","E7849","R002","R944","F3341","E782","R609","R739","H81.13","E55.9","F33.1","M79.7","F32.A","H26.9","F32.9","L01.00","R53.82","Z76.89","J30.2","G93.3","H35.3132","H40.013","H25.13","H43.813","H52.13","H52.203","Z86.16","Z87.01","Z79.01","I82.542","R06.02","R06.09","U09.9","R09.02","I82.442","E07.9","G43.909","R30.0","N30.00","U07.1","I82.409","A41.89","J96.01","J12.82","E87.6","F41.8","F42.9","I82.402","A41.9","M79.671","E86.0","Z20.828","R40.20","R00.1","B34.9","E78.49","R00.2","R94.4","F33.41","E78.2","R60.9","R73.9"],"date":["2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-06-19","2023-05-23","2022-11-16","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-09-01","2022-09-01","2022-09-01","2022-08-17","2022-07-05","2022-07-05","2022-06-06","2022-05-23","2022-05-09","2022-04-19","2022-04-19","2022-04-19","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-03-07","2022-03-07","2022-03-04","2022-03-04","2022-03-01","2022-02-22","2022-02-22","2022-02-10","2022-01-12","2021-12-22","2021-12-22","2021-12-21","2021-12-21","2021-12-09","2021-12-09","2021-12-04","2021-12-05","2021-12-06","2021-11-24","2021-11-24","2021-12-06","2021-12-06","2021-11-26","2021-11-24","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-17","2021-11-08","2021-10-11","2021-08-16","2021-07-06","2021-05-12","2021-05-10","2021-05-10","2022-11-16","2022-11-07","2022-11-07","2022-11-07","2022-09-01","2022-09-01","2022-07-05","2022-07-05","2022-05-23","2022-05-09","2022-04-19","2022-04-19","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-03-30","2022-03-07","2022-03-07","2022-03-04","2022-03-04","2022-03-01","2022-02-22","2022-02-22","2022-02-10","2022-01-12","2021-12-22","2021-12-22","2021-12-21","2021-12-21","2021-12-09","2021-12-09","2021-12-04","2021-12-05","2021-12-06","2021-11-24","2021-11-24","2021-12-06","2021-12-06","2021-11-26","2021-11-24","2021-11-18","2021-11-18","2021-11-18","2021-11-18","2021-11-17","2021-11-08","2021-10-11","2021-08-16","2021-07-06","2021-05-12","2021-05-10","2021-05-10"],"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":[["","","ARMOUR THYROID","90","30","Select","Select",""],["","","CITALOPRAM HYDROBROMIDE","20","90","Select","Select",""],["","","FENOFIBRATE","160.000MG","30","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","0.00%","30","Select","Select",""],["","","CLOTRIMAZOLE","10.000MG","30","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","10.000MG","180","Select","Select",""],["","","MUPIROCIN","2.00%","22","Select","Select",""],["","","FLUCONAZOLE","100.000MG","16","Select","Select",""],["","","NYSTATIN","100000.000UNIT\/ML","60","Select","Select",""],["","","GABAPENTIN","100.000MG","90","Select","Select",""],["","","ALPRAZOLAM","0.000MG","20","Select","Select",""],["","","HYDROCORTISONE","2.00%","30","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":""}]}]}