{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J ELYAGNOSNHO","gend":0,"add":"LTSAC 5351EVA KCORE","city":"WENATCHEE","state":"WA","zip":98801,"dob":"1948-08-29","age":"","mstatus":"","insh":"90604910281","cliId":"","pno":"9460247519","cno":"2064991574","email":"","ename":"","eno":"","pphy":"KATHRYN EREN","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"Douglas","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"APT #52","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":"1629365598"},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M17.0","Z0000","D509","I129","N1831","E7800","N1830","J4520","J449","Z23","M170","M21161","M21162","M25461","I10","E785","H353122","H2513","H52223","H524","H353210","Z1159","D649","Z87828","Z8781","Z9842","Z9841","R0789","N183","J45909","Z00.00","D50.9","I12.9","N18.31","E78.00","N18.30","J45.20","J44.9","M21.161","M21.162","M25.461","E78.5","H35.3122","H25.13","H52.223","H52.4","H35.3210","Z11.59","D64.9","Z87.828","Z87.81","Z98.42","Z98.41","R07.89","N18.3","J45.909"],"date":["2023-05-23","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2021-08-30","2021-08-30","2021-05-17","2021-05-17","2021-05-17","2021-05-17","2021-05-17","2021-03-29","2021-03-29","2021-03-29","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-07-17","2020-07-08","2022-11-29","2022-11-29","2022-11-29","2022-11-29","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2022-11-15","2021-08-30","2021-05-17","2021-05-17","2021-05-17","2021-05-17","2021-05-17","2021-03-29","2021-03-29","2021-03-29","2020-08-13","2020-08-13","2020-08-13","2020-08-13","2020-07-17","2020-07-08"],"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","100","90","Select","Select",""],["","","ATORVASTATIN CALCIUM","20","90","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12","90","Select","Select",""],["","","VENTOLIN HFA","108.000MCG\/ACT","36","Select","Select",""],["","","FLUTICASONE PROPIONATE\/SALMETEROL","0","-3","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":""}]}]}