{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"K ardnaSecnirP ","gend":1,"add":"hcnaR 001daoR esuo","city":"Burleson","state":"TX   ","zip":76028,"dob":"1945-11-07","age":"","mstatus":"","insh":"921901033","cliId":"","pno":"92-7189572-5","cno":"","email":"","ename":"","eno":"","pphy":"Stewart, Angelene Marcell","ppno":"817-294-5624","pcpadd":"7120 McCart Ave, ","pcpcity":"Fort Worth","pcpstate":"TX","pcpzip":76133,"pcpcounty":"","pcpid":"","pcpname":"Ronald A Stewart DO PA","plan":"UHC","program":"Southwestern Health Resources","lob":"","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"","madd2":"","madd3":"","mcity":"","mstate":"","mzip":"","pcpfaxno":"","pcpnpi":1710923149},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.22","I25.118","N179","E66.01"],"date":["2022-07-22","2022-07-22","2022-04-19","2022-02-17"],"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":[["","93720210","PRAVASTATIN","TAB 40MG","100","Select","Select",""],["","8290320883","BD PEN NEEDL","MIS 32GX4MM","90","Select","Select",""],["","50458057989","XARELTO","TAB 20MG","100","Select","Select",""],["","50742061510","METOPROL SUC","TAB 25MG ER","100","Select","Select",""],["","68180051303","LISINOPRIL","TAB 5MG","100","Select","Select",""],["","53885024510","ONETOUCH","TES ULTRA","500","Select","Select",""],["","16729000316","GLIMEPIRIDE","TAB 4MG","100","Select","Select",""],["","31722072250","LEVOFLOXACIN","TAB 500MG","10","Select","Select",""],["","69238183107","LEVOTHYROXIN","TAB 50MCG","100","Select","Select",""],["","70756021551","FENOFIBRATE","TAB 160MG","100","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":""}]}]}