{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael K Graham","gend":0,"add":"160 Maner Road","city":"Rockmart","state":"GA","zip":30153,"dob":"1960-03-23","age":"","mstatus":"","insh":4535450001,"cliId":"","pno":7706841578,"cno":"","email":"michgrah1960@gmail.com","ename":"","eno":"","pphy":"LEIA DAWSON","ppno":"","pcpadd":"1650 Chattahoochee Dr","pcpcity":"Rockmart","pcpstate":"GA","pcpzip":"","pcpcounty":"Rockmart","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":["M86.172","L97.529","L02.612","L03.116","J20.9","R06.02","R53.83","R05","I73.9","Z87.891","K21.9","I12.9","N18.30","Z20.822","L02.222","L97.522","G60.9","Z71.3","M86.9","Z13.9","M25.521","M25.621","M25.421","S52.134","L97.526","L03.032","I10","Z11.59","R73.03","L72.3","K02.9","S60.450","Z89.422","B95.1","B95.2","B95.7","K59.00","Z88.0","Z79.899","M89.8X7","J20.5","M19.90","R79.89","J06.9","B97.4","R73.9","F17.210","L97.521","M25.531","S52.131","S60.211","L08.9","S52.124","G89.11","R09.02","M79.672","Z89.412","I73.00","T87.44","A49.1","R06.00","Z47.81","R10.9","L97.524","R00.0","I45.10","R94.31","Z03.818"],"date":["2020-07-28","2020-07-28","2020-08-11","2020-08-11","2022-01-04","2022-01-04","2021-09-21","2022-01-06","2021-09-21","2021-09-21","2022-01-06","2022-01-04","2022-01-04","2022-01-04","2021-01-06","2020-07-14","2020-07-14","2020-07-14","2020-08-04","2020-07-14","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2020-08-11","2020-08-11","2022-01-06","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-08-11","2020-12-08","2020-12-08","2020-08-11","2022-01-06","2022-01-06","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2022-01-04","2020-06-30","2021-01-12","2021-01-12","2020-12-22","2020-07-28","2020-12-22","2020-12-22","2022-01-04","2020-07-28","2020-07-28","2020-07-14","2020-08-11","2020-08-04","2022-01-06","2020-07-28","2020-07-28","2020-07-28","2021-11-09","2021-11-09","2021-11-09","2020-07-28"],"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":[["","69097084615","CYCLOBENZAPRINE","10MGTABLET","90","Select","Select",""],["","68645055354","LISINOPRIL","20MGTABLET","30","Select","Select",""],["","68682010610","NIFEDIPINE","ER60MGTABLET","30","Select","Select",""],["","603533715","PREDNISONE","5MGTABDOSEPACK","21","Select","Select",""],["","50111078751","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","67877021905","CEPHALEXIN","500MGCAPSULE","30","Select","Select",""],["","68180096301","ALBUTEROL","HFA90MCGINHALER","8.5","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TMP","DSTABLET","28","Select","Select",""],["","33342002332","LEVOFLOXACIN","750MGTABLET","3","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":""}]}]}