{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"AN ANALEROMARR","gend":1,"add":"XOB OP0702 ","city":"LEAVENWORTH","state":"WA","zip":98826,"dob":"1941-10-28","age":"","mstatus":"","insh":"90604910678","cliId":"","pno":"4590537808","cno":"5095480873","email":"","ename":"","eno":"","pphy":" ","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","pcpid":"","pcpname":"","plan":"Health Alliance","program":"Medicare Advantage","lob":"Confluence","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E21.3","E83.52","Z96.651","M25.661","Z47.1","R26.89","M1711","Z23","R0600","I517","M170","M25861","M8568","M1712","M25862","M8580","E213","E8352","Z85850","Z8639","Z136","I10","H524","H25813","C73","E042","E039","E785","S29012D","S29012A","M25512","N3946","L821","L989","K219","R69","Z1231","E890","E041","F79","Z0100","H2513","H11153","H43813","E1136","H00021","H538","R0609","R5383","R42","F329","E7801","H0014","L570","D234","L720","H00024","L820","Z1239","Z8262","H25811","H25812","M17.11","R06.00","I51.7","M17.0","M25.861","M85.68","M17.12","M25.862","M85.80","Z85.850","Z86.39","Z13.6","H52.4","H25.813","E04.2","E03.9","E78.5","S29.012D","S29.012A","M25.512","N39.46","L82.1","L98.9","K21.9","Z12.31","E89.0","E04.1","Z01.00","H25.13","H11.153","H43.813","E11.36","H00.021","H53.8","R06.09","R53.83","F32.9","E78.01","H00.14","L57.0","D23.4","L72.0","H00.024","L82.0","Z12.39","Z82.62","H25.811","H25.812"],"date":["2023-06-20","2023-06-12","2023-05-23","2023-05-23","2023-05-02","2023-05-02","2022-10-25","2022-11-01","2022-08-02","2022-08-02","2022-07-19","2022-07-06","2022-07-06","2022-07-06","2022-07-06","2022-07-01","2022-07-01","2022-06-21","2022-06-21","2022-06-21","2022-06-08","2023-01-27","2022-05-31","2022-05-31","2022-06-16","2022-05-26","2022-05-17","2022-05-16","2021-11-22","2021-11-16","2021-11-16","2021-11-16","2021-10-01","2021-10-01","2021-10-01","2021-09-20","2021-07-12","2021-06-17","2021-06-17","2021-06-28","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-12","2021-05-12","2021-04-30","2021-04-30","2021-05-10","2021-04-30","2021-04-27","2020-12-02","2020-11-11","2020-11-11","2020-11-11","2020-11-11","2020-07-06","2020-07-06","2020-07-06","2020-07-01","2020-07-01","2022-11-03","2023-01-27","2022-08-09","2022-07-28","2022-07-28","2022-07-28","2022-07-27","2022-07-27","2022-07-29","2022-07-25","2022-07-25","2022-07-05","2022-06-03","2022-06-03","2022-06-16","2022-10-12","2022-08-12","2021-12-06","2021-12-14","2021-12-14","2021-12-14","2021-10-20","2021-10-20","2022-08-12","2021-07-16","2022-04-07","2022-10-12","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2022-04-07","2021-12-22","2021-12-22","2021-05-10","2021-05-10","2022-08-12","2021-05-04","2020-12-30","2020-11-17","2020-11-17","2020-11-17","2020-11-23","2020-07-13","2020-07-14","2021-03-18","2020-07-08","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":[["","","OXYBUTYNIN CHLORIDE ER","10","90","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12","30","Select","Select",""],["","","LISINOPRIL","40","30","Select","Select",""],["","","SIMVASTATIN","10","30","Select","Select",""],["","","CINACALCET HYDROCHLORIDE","30.000MG","90","Select","Select",""],["","","LEVOTHYROXINE SODIUM","125.000MCG","90","Select","Select",""],["","","CELECOXIB","200.000MG","14","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5.000MG","40","Select","Select",""],["","","PAXLOVID","0","30","Select","Select",""],["","","OMEPRAZOLE","20.000MG","42","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":""}]}]}