{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Delores Blash","gend":1,"add":"5004 Nisbet Dr.","city":"Macon","state":"GA","zip":31206,"dob":"1957-09-19","age":"","mstatus":"","insh":4226663001,"cliId":"","pno":4787873128,"cno":"","email":"d57blash@yahoo.com","ename":"","eno":"","pphy":" ","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","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":["I69.351","I69.398","G44.1","E11.65","I11.9","D72.829","Z20.822","F41.9","K42.9","D64.9","Z79.4","I61.9","J96.00","I16.1","R13.19","R73.9","I62.9","R41.82","J96.01","J69.0","R57.8","G81.91","G91.9","E87.1","G93.40","R29.810","R13.12","I61.0","E87.6","Z66","Z51.5","K59.00","K21.9","E78.1","E11.649","I69.151","I69.120","I69.192","I10","I69.191","K46.9","D75.839","E55.9","R26.89","R00.0","R47.01","N39.0","G47.37","E78.5","R13.10","E11.9","E66.9","Z68.29","Z79.899","I63.9","I61.8","Z46.82","R26.9","M62.81","Z74.01","Z91.81","J18.9","B96.89","Z46.59","Z71.89","J90","I34.0","I34.8","I36.1","I35.8","I51.7","I60.9","I61.5","J96.90","I20.9","R07.89","R07.9","R73.09","Z45.2","R06.02","I24.9","G45.8","R91.8","R41.0","R47.81","R19.00","R10.9"],"date":["2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2021-12-28","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-12-28","2021-12-28","2021-12-21","2022-01-06","2021-11-23","2022-01-04","2021-11-23","2022-01-06","2022-01-04","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-12-21","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-12-21","2021-12-21","2021-12-21","2022-01-06","2021-12-21","2021-12-21","2021-12-21","2021-12-21","2021-12-21","2021-12-21","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2021-12-28","2022-01-06","2021-12-28","2022-01-04","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-16","2021-12-28","2021-11-30","2021-12-28","2021-11-23","2021-12-28","2021-11-23","2021-12-28","2021-12-08","2021-12-28","2021-12-28","2021-12-14","2021-12-14","2021-12-08","2021-12-08","2021-11-09","2022-01-06","2021-11-30","2022-01-04","2021-12-08","2021-11-23","2021-12-28","2021-11-09","2021-11-09"],"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":[["","57664047758","METOPROLOL","TARTRATE50MGTAB","60","Select","Select",""],["","68180096301","ALBUTEROL","HFA90MCGINHALER","8.5","Select","Select",""],["","67877019910","AMLODIPINE","BESYLATE10MGTAB","30","Select","Select",""],["","31722052110","HYDRALAZINE","50MGTABLET","90","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":""}]}]}