{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"H DEKCUA","gend":0,"add":"YRREHC 0551202 TPA TS ","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1937-09-16","age":"","mstatus":"","insh":"80604910236","cliId":"","pno":"8790552282","cno":"5097828225","email":"","ename":"","eno":"","pphy":"MARY TIMIRAS","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":"1750313987"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L57.0","L57.8","L82.1","R31.29","R31.0","Z09","E11.329","Z79.84","D35.2","I69.398","G31.9","E23.6","Z45018","I4430","I442","G3184","I69320","I69398","R2689","E1122","I5032","Z8673","Z23","R69","Z48812","Z950","Z139","L089","D352","I441","I10","U071","G928","N179","I130","E872","J9859","E162","G9341","R000","I517","A499","R509","I498","R9431","J9811","K760","I959","R001","R410","I440","I672","R29818","R270","I6789","I6522","M47812","R42","N1830","I69328","E113292","N1831","M25522","M1000","M19022","R2232","I6389","G8191","R4189","R29810","R4701","I639","E236","E1151","I492","I454","E119","Z20822","I129","I6523","I6601","I6623","R202","R471","N182","Z7984","E237","H539","I69318","H538","I2510","I7091","J320","G459","H5340","H25813","G453","R519","R5383","Z0000","E782","E1129","M10072","L570","L821","L738","R0981","J069","B9789","N189","L814","L853","S20361D","I96","L03313","I252","I110","Z125","L739","H8110","J0110","L820","L720","H524","H52223","E1136","Z45.018","I44.30","I44.2","G31.84","I69.320","R26.89","E11.22","I50.32","Z86.73","Z48.812","Z95.0","Z13.9","L08.9","I44.1","U07.1","G92.8","N17.9","I13.0","E87.2","J98.59","E16.2","G93.41","R00.0","I51.7","A49.9","R50.9","I49.8","R94.31","J98.11","K76.0","I95.9","R00.1","R41.0","I44.0","I67.2","R29.818","R27.0","I67.89","I65.22","M47.812","N18.30","I69.328","E11.3292","N18.31","M25.522","M10.00","M19.022","R22.32","I63.89","G81.91","R41.89","R29.810","R47.01","I63.9","E11.51","I49.2","I45.4","E11.9","Z20.822","I12.9","I65.23","I66.01","I66.23","R20.2","R47.1","N18.2","E23.7","H53.9","I69.318","H53.8","I25.10","I70.91","J32.0","G45.9","H53.40","H25.813","G45.3","R51.9","R53.83","Z00.00","E78.2","E11.29","M10.072","L73.8","R09.81","J06.9","B97.89","N18.9","L81.4","L85.3","S20.361D","L03.313","I25.2","I11.0","Z12.5","L73.9","H81.10","J01.10","L82.0","L72.0","H52.4","H52.223","E11.36"],"date":["2023-05-31","2023-05-31","2023-05-31","2023-05-25","2023-05-23","2023-05-11","2023-05-11","2023-05-11","2023-05-11","2023-04-25","2023-04-25","2023-04-25","2022-12-19","2022-12-19","2022-12-19","2022-11-17","2022-11-17","2022-11-17","2022-11-17","2022-11-16","2022-11-16","2022-11-16","2022-11-16","2022-11-03","2022-10-19","2022-10-19","2022-10-17","2022-10-17","2022-10-11","2022-09-18","2022-09-14","2022-09-05","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-09-04","2022-09-05","2022-09-05","2022-09-04","2022-09-04","2022-09-04","2022-09-03","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-01","2022-09-01","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-24","2022-08-24","2022-08-24","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-11","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-11","2022-08-11","2022-08-11","2022-08-10","2022-08-10","2022-08-10","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-07-25","2022-07-23","2022-07-21","2022-07-18","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-06-27","2022-06-27","2022-06-21","2022-06-21","2022-06-09","2022-06-09","2022-06-02","2022-06-02","2022-06-02","2022-03-30","2022-03-30","2022-03-30","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-09-30","2021-09-30","2021-06-14","2021-06-14","2021-06-03","2021-04-08","2021-04-08","2021-04-06","2021-02-19","2020-12-17","2020-11-29","2020-09-16","2020-08-12","2020-07-20","2020-07-20","2020-07-20","2022-12-19","2022-12-19","2022-12-19","2022-11-17","2022-11-17","2022-11-17","2022-11-16","2022-11-16","2022-11-16","2022-10-19","2022-10-19","2022-10-17","2022-10-17","2022-09-18","2022-09-05","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-09-04","2022-09-05","2022-09-05","2022-09-04","2022-09-04","2022-09-04","2022-09-03","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-09-01","2022-09-01","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-08-24","2022-08-24","2022-08-24","2022-08-18","2022-08-18","2022-08-18","2022-08-18","2022-08-11","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-11","2022-08-11","2022-08-10","2022-08-10","2022-08-10","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-08-08","2022-07-23","2022-07-21","2022-07-18","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-07-14","2022-06-27","2022-06-27","2022-06-21","2022-06-21","2022-06-09","2022-06-09","2022-06-02","2022-06-02","2022-06-02","2022-03-30","2021-11-24","2021-11-24","2021-11-24","2021-11-24","2021-09-30","2021-09-30","2021-06-14","2021-06-03","2021-04-08","2021-04-08","2021-04-06","2021-02-19","2020-12-17","2020-11-29","2020-09-16","2020-08-12","2020-07-20","2020-07-20","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":[["","","LOSARTAN POTASSIUM","25","30","Select","Select",""],["","","ATORVASTATIN CALCIUM","80","30","Select","Select",""],["","","GLIPIZIDE","10","60","Select","Select",""],["","","JARDIANCE","10","30","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","150","30","Select","Select",""],["","","CLOPIDOGREL","75","30","Select","Select",""],["","","PFIZER-BIONTECH COVID-19 VACCINE\/BIVALENT\/BA.4\/BA.5","30.000MCG\/0.3ML","0","Select","Select",""],["","","LOPERAMIDE HYDROCHLORIDE","2.000MG","30","Select","Select",""],["","","MIRTAZAPINE","15.000MG","28","Select","Select",""],["","","SERTRALINE HCL","50.000MG","30","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","0.00%","473","Select","Select",""],["","","FREESTYLE LITE TEST STRIPS","0","50","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":""}]}]}