{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barry N Spector","gend":0,"add":"290 Shenandoah Dr NE","city":"Calhoun","state":"GA","zip":30701,"dob":"1958-04-23","age":"","mstatus":"","insh":4531038002,"cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"PHILLIP GRAY","ppno":"","pcpadd":"400 Timms Road NE,N","pcpcity":"Calhoun","pcpstate":"GA","pcpzip":"","pcpcounty":"Calhoun","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":["N18.3","N40.0","Z85.528","J45.909","Z85.828","N25.81","M62.81","R29.3","M25.512","M25.612","M25.522","I82.609","R03.0","F41.1","Z68.28","M75.102","Z13.828","Z00.00","J45.20","Z23","Z12.11","Z12.12","D30.22","H25.11","R31.0","N13.1","Z79.51","Z01.818","U07.1","J20.9","N13.2","N17.9","I10","R09.02","N40.1","Z87.442","N52.9","D41.22","N20.0","C44.519","H25.819","R79.89","C66.9","M75.122","M75.02","I82.622","D49.59","N18.31","C64.9","L90.5","Z20.828","N18.30","Z90.5","L82.0","D48.5","M79.673","N41.8","R97.20","Z85.54","M19.072","M79.672","M10.9","N13.5","H43.813","Z96.1","N28.1","D41.21","D41.4","R39.89","N28.89","Q66.82","Z71.9","E66.3","R82.89","R82.998","L08.9","S40.012","H33.312","H04.123","D22.9","I78.9","D18.01","L82.1","J43.9","J98.4","G89.18","H43.811","C66.2","Z98.890","H35.372","Z79.899"],"date":["2021-02-11","2021-12-14","2021-03-30","2021-04-13","2021-09-07","2020-10-13","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-05-11","2021-09-14","2021-08-17","2021-08-17","2021-09-14","2021-04-27","2021-04-27","2020-03-10","2021-01-12","2020-03-10","2020-03-10","2020-03-10","2020-03-10","2021-03-23","2020-05-26","2020-03-24","2020-03-24","2021-01-12","2021-01-26","2021-01-26","2020-04-09","2020-04-09","2021-03-30","2020-04-09","2020-12-08","2020-04-09","2020-04-09","2020-04-09","2021-12-14","2020-06-16","2021-01-12","2021-01-12","2021-01-12","2021-10-12","2021-04-13","2021-06-01","2020-02-18","2021-12-14","2021-12-14","2020-06-09","2020-09-08","2021-03-30","2021-03-30","2020-04-28","2020-04-28","2021-12-14","2020-02-25","2020-12-08","2021-03-23","2021-02-11","2021-02-11","2021-02-16","2020-03-03","2021-12-14","2021-12-14","2020-10-06","2020-02-04","2020-03-03","2020-03-03","2020-03-24","2020-03-31","2020-03-31","2020-03-31","2020-02-11","2020-01-28","2020-06-16","2021-02-11","2021-04-06","2021-03-09","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2020-02-18","2020-02-18","2021-04-13","2021-03-09","2020-07-14","2021-08-10","2020-03-10","2020-02-25"],"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":[["","66993058597","FLUTICASONE-SALMETEROL","250-50","60","Select","Select",""],["","68382013210","TAMSULOSIN","HCL0.4MGCAPSULE","30","Select","Select",""],["","173068220","VENTOLIN","HFA90MCGINHALER","18","Select","Select",""],["","68180012202","CEPHALEXIN","500MGCAPSULE","30","Select","Select",""],["","24208050707","LOTEMAX","SM0.0038OPHTHGEL","5","Select","Select",""],["","54092060601","XIIDRA","0.05EYEDROPS","60","Select","Select",""],["","406012301","HYDROCODONE-ACETAMIN","5-325MG","15","Select","Select",""],["","51862006310","DIAZEPAM","5MGTABLET","26","Select","Select",""],["","35573041030","TADALAFIL","5MGTABLET","30","Select","Select",""],["","54485925","TRIAZOLAM","0.25MGTABLET","2","Select","Select",""],["","173069600","ADVAIR","250-50DISKUS","60","Select","Select",""],["","59267100001","PFIZER","COVID-19VACCINE(EUA)","0.3","Select","Select",""],["","61314039601","CYCLOPENTOLATE","0.01EYEDROPS","2","Select","Select",""],["","603459315","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","10702000750","CYCLOBENZAPRINE","10MGTABLET","21","Select","Select",""],["","781261305","AMOXICILLIN","500MGCAPSULE","30","Select","Select",""],["","24208044605","BESIVANCE","0.006SUSP","5","Select","Select",""],["","3089421","ELIQUIS","5MGTABLET","60","Select","Select",""],["","781217660","CEFDINIR","300MGCAPSULE","10","Select","Select",""],["","485015101","UROGESIC-BLUE","TABLET","30","Select","Select",""],["","378415105","TRAMADOL","HCL50MGTABLET","30","Select","Select",""],["","24208060203","PROLENSA","0.0007EYEDROPS","3","Select","Select",""],["","68180016013","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","59746017509","PREDNISONE","20MGTABLET","20","Select","Select",""],["","10135062101","PHENAZOPYRIDINE","200MGTAB","30","Select","Select",""],["","16714004110","ALLOPURINOL","100MGTABLET","30","Select","Select",""],["","58657045401","ME-NAPHOS-MB-HYO","1TABLET","100","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TMP","DSTABLET","14","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":""}]}]}