{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DNOMYARSLLEW ","gend":0,"add":"IT 5897NL YLL","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1952-04-01","age":"","mstatus":"","insh":"88904910372","cliId":"","pno":"6890591550","cno":"5098605519","email":"","ename":"","eno":"","pphy":"TOBY LONG","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":"1033116215"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R35.1","R53.82","E78.00","I10","R06.02","E78.5","R06.09","Z87.891","G43719","E781","M8589","M5090","M19031","G8929","Z87891","M25531","H60501","M25561","Z96651","Z471","M65311","Z0000","E7800","R351","R569","M5481","G43909","Z1159","E038","G43919","M25551","E039","S22000A","M542","M8580","S22050D","S22000G","M810","G43709","M8008XA","D1809","M40294","M8000XA","M47812","M438X4","L570","Z9109","R2241","M25461","N528","Z20828","Z1289","M7521","M25511","Z96611","G43.719","E78.1","M85.89","M50.90","M19.031","G89.29","M25.531","H60.501","M25.561","Z96.651","Z47.1","M65.311","Z00.00","R56.9","M54.81","G43.909","Z11.59","E03.8","G43.919","M25.551","E03.9","S22.000A","M54.2","M85.80","S22.050D","S22.000G","M81.0","G43.709","M80.08XA","D18.09","M40.294","M80.00XA","M47.812","M43.8X4","L57.0","Z91.09","R22.41","M25.461","N52.8","Z20.828","Z12.89","M75.21","M25.511","Z96.611"],"date":["2023-05-23","2023-05-23","2023-05-23","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2023-04-17","2022-12-29","2022-12-27","2022-11-16","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-08-18","2022-07-19","2022-05-24","2022-05-24","2022-05-24","2022-05-19","2022-05-19","2022-03-15","2022-03-15","2022-03-15","2022-01-26","2022-01-26","2022-01-18","2022-01-18","2022-01-18","2021-11-24","2021-11-24","2021-07-16","2021-06-29","2021-06-29","2021-06-29","2021-05-24","2021-05-24","2021-05-17","2021-04-28","2021-04-28","2021-04-28","2021-04-06","2021-04-06","2021-04-06","2021-03-18","2021-02-22","2021-01-25","2021-01-14","2021-01-06","2020-11-16","2020-11-11","2020-07-28","2020-07-28","2020-07-28","2022-12-29","2022-12-27","2022-11-16","2022-11-07","2022-11-07","2022-11-07","2022-08-18","2022-07-19","2022-05-24","2022-05-24","2022-05-24","2022-05-19","2022-05-19","2022-03-15","2022-01-26","2022-01-26","2022-01-18","2022-01-18","2022-01-18","2021-11-24","2021-11-24","2021-07-16","2021-06-29","2021-06-29","2021-06-29","2021-05-24","2021-05-24","2021-05-17","2021-04-28","2021-04-28","2021-04-28","2021-04-06","2021-04-06","2021-04-06","2021-03-18","2021-02-22","2021-01-25","2021-01-14","2021-01-06","2020-11-16","2020-11-11","2020-07-28","2020-07-28","2020-07-28"],"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":[["","","LISINOPRIL","40","90","Select","Select",""],["","","SUMATRIPTAN","20","6","Select","Select",""],["","","TRAMADOL HCL","50","120","Select","Select",""],["","","AIMOVIG","140","1","Select","Select",""],["","","ATORVASTATIN CALCIUM","20","90","Select","Select",""],["","","RIZATRIPTAN BENZOATE ODT","10","10","Select","Select",""],["","","LEVOTHYROXINE SODIUM","75.000MCG","90","Select","Select",""],["","","IBANDRONATE SODIUM","150.000MG","-3","Select","Select",""],["","","METHOCARBAMOL","750.000MG","540","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE","60.000MG","90","Select","Select",""],["","","GABAPENTIN","300.000MG","360","Select","Select",""],["","","ALBUTEROL SULFATE HFA","108.000MCG\/ACT","18","Select","Select",""],["","","NEOMYCIN\/POLYMYXIN\/HYDROCORTISONE","0","10","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":""}]}]}