{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Larry K Bruce","gend":0,"add":"38 Shuford St","city":"Lavonia","state":"GA","zip":30553,"dob":"1961-05-13","age":"","mstatus":"","insh":1858433001,"cliId":"","pno":7064981934,"cno":"","email":"hikerfc@gmail.com","ename":"","eno":"","pphy":"SUBODH AGRAWAL","ppno":"","pcpadd":"11973 Augusta Rd","pcpcity":"Lavonia","pcpstate":"GA","pcpzip":"","pcpcounty":"Lavonia","pcpid":"","pcpname":"","plan":"ALLIANT","program":"ACA","lob":"","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":["I10","R42","R07.9","J44.9","R06.02","F33.8","F41.1","K21.9","E66.01","E78.00","N52.9","R00.2","Z68.34","D51.8","Z68.32","E87.6","R53.82","Z13.29","R51","E55.9","F41.9","R37","R07.89","Z79.899"],"date":["2021-12-28","2021-12-28","2020-07-28","2020-06-30","2020-06-30","2020-05-19","2020-08-25","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2022-01-06","2021-06-22","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2020-07-28","2021-12-28","2020-07-21","2021-01-06","2021-11-23","2020-12-22"],"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":[]}]},{"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":[["","68001024617","ONDANSETRON","ODT4MGTABLET","12","Select","Select",""],["","51862006205","DIAZEPAM","2MGTABLET","20","Select","Select",""],["","68001033508","LISINOPRIL","20MGTABLET","30","Select","Select",""],["","68001035703","METOPROLOL","SUCCER50MGTAB","30","Select","Select",""],["","29300013005","HYDROCHLOROTHIAZIDE","12.5MGCP","30","Select","Select",""],["","16729016917","ESCITALOPRAM","10MGTABLET","30","Select","Select",""],["","13107003134","MIRTAZAPINE","15MGTABLET","30","Select","Select",""],["","781261305","AMOXICILLIN","500MGCAPSULE","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":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"a":{"indx":["","1"],"comment":["",""]}},{"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":""}]}]}