{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James R Butcher","gend":0,"add":"3537 Hwy 76 W","city":"Clayton","state":"GA","zip":30525,"dob":"1960-08-25","age":"","mstatus":"","insh":902661001,"cliId":"","pno":7069821559,"cno":"","email":"jrbutcher60@gmail.com","ename":"","eno":"","pphy":"EDWARD FREDERICKSON","ppno":"","pcpadd":"156 North Main Street,N","pcpcity":"Clayton","pcpstate":"GA","pcpzip":"","pcpcounty":"Clayton","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":["Z12.11","R51.9","I10","R73.03","R11.0","R61","I25.10","Z79.899","Z90.49","Z96.641","Z20.822","Z48.03","Z91.81","M54.5","M25.551","R35.0","D50.9","R07.2","R10.13","M16.11","M47.22","M47.812","R29.3","R26.9","R07.9","K21.9","M54.17","Z13.89","Z68.29","M54.41","G89.29","S76.111","N28.1","E55.9","E66.01","Z68.30","Z71.3","M54.16","M51.36","M54.2","E61.1","M54.6","Z47.1","R94.31","K22.70","D12.8","K29.60","K64.0","K31.7","K21.00","Z01.89","R10.31","Z87.442","N20.0","E66.3","Z68.31","Z76.0","R00.0","Z51.81","F41.9","M79.604","M48.061","G57.11","M54.51","F11.20","M54.31","R30.0","M51.24","M48.04","Z20.828","M47.816","D13.1"],"date":["2021-08-24","2021-06-29","2021-12-08","2021-06-29","2021-07-06","2021-07-06","2021-06-29","2021-11-09","2021-06-29","2021-09-01","2021-07-20","2020-12-15","2020-12-15","2021-10-13","2021-08-05","2021-11-09","2020-11-03","2021-07-20","2021-08-24","2020-11-03","2020-07-21","2020-07-21","2020-03-24","2020-03-24","2021-07-06","2020-02-18","2020-12-01","2020-02-18","2020-02-18","2021-11-02","2021-12-28","2021-05-18","2021-06-22","2021-11-09","2020-07-21","2020-07-21","2021-02-02","2021-11-16","2021-10-19","2020-10-27","2021-06-22","2021-10-26","2021-05-04","2021-06-22","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-08-24","2021-01-19","2021-09-01","2021-09-01","2021-08-31","2021-02-02","2021-02-02","2020-12-15","2020-11-24","2020-08-25","2021-12-28","2021-05-11","2021-05-11","2021-12-28","2021-12-28","2020-12-01","2021-10-13","2021-02-02","2021-10-19","2021-10-19","2021-01-19","2020-01-22","2021-08-17"],"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":[]}]},{"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":[["","57237000299","HYDROCHLOROTHIAZIDE","12.5MGCP","30","Select","Select",""],["","50111043302","TRAZODONE","50MGTABLET","30","Select","Select",""],["","53746020401","OXYCODONE-ACETAMINOPHEN","10-325","120","Select","Select",""],["","68462018022","MUPIROCIN","0.02OINTMENT","22","Select","Select",""],["","68001016208","PROMETHAZINE","25MGTABLET","20","Select","Select",""],["","33342015715","CELECOXIB","200MGCAPSULE","30","Select","Select",""],["","406055201","OXYCODONE","HCL5MGTABLET","40","Select","Select",""],["","406012505","HYDROCODONE-ACETAMIN","10-325MG","120","Select","Select",""],["","43547033610","BENAZEPRIL","HCL10MGTABLET","30","Select","Select",""],["","57664037713","TRAMADOL","HCL50MGTABLET","40","Select","Select",""],["","378023110","ATENOLOL","50MGTABLET","30","Select","Select",""],["","781261305","AMOXICILLIN","500MGCAPSULE","10","Select","Select",""],["","16729013616","CLONAZEPAM","0.5MGTABLET","60","Select","Select",""],["","65862001905","CEPHALEXIN","500MGCAPSULE","16","Select","Select",""],["","378668999","PANTOPRAZOLE","SODDR40MGTAB","30","Select","Select",""],["","64380080707","IBUPROFEN","800MGTABLET","20","Select","Select",""],["","143122710","DICYCLOMINE","20MGTABLET","60","Select","Select",""],["","46122018076","ASPIRIN","EC81MGTABLET","60","Select","Select",""],["","45802016000","DICLOFENAC","SODIUM0.01GEL","300","Select","Select",""],["","65862064169","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","65862053750","LEVOFLOXACIN","500MGTABLET","10","Select","Select",""],["","80777027399","MODERNA","COVID-19VACCINE(EUA)","0.5","Select","Select",""],["","527135301","HYDROMORPHONE","2MGTABLET","24","Select","Select",""],["","57237007710","ONDANSETRON","ODT4MGTABLET","5","Select","Select",""],["","52817033200","CYCLOBENZAPRINE","10MGTABLET","30","Select","Select",""],["","50228018005","GABAPENTIN","300MGCAPSULE","30","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","48102004701","DEXAMETHASONE","4MGTABLET","15","Select","Select",""],["","55566670001","CLENPIQ","SOLUTION","320","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":""}]}]}