{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael D Adams","gend":0,"add":"5461 Woodrun Ct.","city":"Braselton","state":"GA","zip":30517,"dob":"1969-04-30","age":"","mstatus":"","insh":"AS1001372001","cliId":"","pno":4044838692,"cno":"","email":"mike@adamsbackflow.com","ename":"","eno":"","pphy":"Kelly O'Dell","ppno":"","pcpadd":"4222 Fairbanks Dr","pcpcity":"Oakwood","pcpstate":"GA","pcpzip":"","pcpcounty":"Oakwood","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":["G47.33","Z23","I10","E88.81","I27.81","E29.1","M43.10","Z68.43","M48.061","M48.04","M51.26","M51.24","M54.5","R26.89","R29.898","M62.81","R60.1","R39.89","R73.9","R74.0","Z00.00","Z12.11","N40.0","Z68.42","M79.9","R22.41","Z12.5","M51.36","G89.29","H60.312","M47.816","Z79.899","Z51.81","C44.112","D48.5","I51.89","R09.81","M25.50","Z11.59","Z20.89","J98.8","Z20.828","R05","H02.822","H04.121","Z79.891","E66.01","M43.16","M47.819","M79.18","M47.817"],"date":["2021-12-28","2021-01-12","2021-09-07","2021-09-07","2020-01-14","2021-09-07","2020-01-14","2021-03-02","2020-11-24","2020-11-17","2020-11-17","2020-11-17","2021-06-08","2021-06-08","2021-06-08","2021-06-08","2021-09-07","2020-10-06","2021-09-07","2020-09-29","2020-09-29","2020-07-21","2020-07-21","2021-09-07","2021-09-28","2021-09-28","2021-03-02","2021-03-02","2021-03-02","2021-08-17","2020-12-22","2020-12-22","2020-12-22","2020-05-12","2020-05-05","2020-11-17","2020-11-17","2020-08-11","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2020-08-11","2020-04-28","2020-04-28","2020-12-08","2020-12-08","2021-02-16","2021-02-16","2021-02-16","2020-12-01"],"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":[["","13668025230","OLMESARTAN-HCTZ","40-12.5MGTAB","30","Select","Select",""],["","228212710","CLONIDINE","HCL0.1MGTABLET","30","Select","Select",""],["","67877019805","AMLODIPINE","BESYLATE5MGTAB","30","Select","Select",""],["","378075701","ATENOLOL","100MGTABLET","30","Select","Select",""],["","65862098601","POTASSIUM","CLER8MEQTABLET","30","Select","Select",""],["","65862012701","TORSEMIDE","20MGTABLET","30","Select","Select",""],["","68382075805","METFORMIN","HCL500MGTABLET","30","Select","Select",""],["","31722058230","DULOXETINE","HCLDR30MGCAP","14","Select","Select",""],["","68001028106","DICLOFENAC","SODDR75MGTAB","60","Select","Select",""],["","143965901","TESTOSTERONE","CYP200MG\/ML","6","Select","Select",""],["","69315011710","FUROSEMIDE","40MGTABLET","30","Select","Select",""],["","574402235","BACITRACIN","500UNIT\/GMOPHTH","3.5","Select","Select",""],["","69097095605","PREGABALIN","75MGCAPSULE","60","Select","Select",""],["","24208063110","NEOMYCIN-POLYMYXIN-HC","EARSOLN","10","Select","Select",""],["","143972601","TESTOSTERON","CYP2000MG\/10ML","10","Select","Select",""],["","71093014005","METHOCARBAMOL","500MGTABLET","40","Select","Select",""],["","406052201","OXYCODON-ACETAMINOPHEN","7.5-325","28","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":""}]}]}