{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Randel E Ovbey","gend":0,"add":"1720 Tunnel Hill Rd","city":"Tunnel Hill","state":"GA","zip":30755,"dob":"1959-05-26","age":"","mstatus":"","insh":"AS1003705001","cliId":"","pno":7066717506,"cno":"","email":"rovbey@live.com","ename":"","eno":"","pphy":"MARK ELAM","ppno":"","pcpadd":"1200 W Waugh St","pcpcity":"Dalton","pcpstate":"GA","pcpzip":"","pcpcounty":"Dalton","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":["R05","R51.9","R05.9","R07.0","N17.9","D12.5","K63.5","K57.30","K64.0","Z87.891","Z21","J44.9","I10","G47.33","Z85.820","J44.1","R09.02","B20","Z03.818","F10.21","E66.9","R06.02","R19.7","Z79.82","R53.81","R53.83","K08.89","J45.909","I25.10","F41.9","F32.A","E11.9","E78.00","G47.30","R07.2","R94.31","R07.1","D03.39","R42","R91.8","J98.11","Z68.41","M16.9","Z79.899","F33.3","J02.9","R06.09","E78.5","B15.9","F32.9","Z86.16","Z79.84","Z88.5","R73.9","Z23","M79.673","R53.82","R07.82","D48.5","L82.1","R07.89","Z12.9","Z12.11","K21.9","E66.01","E78.2","L98.9","R09.89","H83.09","D23.5","Z00.00","I77.810","Z20.828","G47.09","U07.1","J22","L21.9","D22.9","D22.5","L56.8","L81.8","L08.9","R60.9","R06.00","R79.89","R07.9","J43.9","D23.39","I51.7","I71.9","I35.1"],"date":["2021-07-13","2021-11-16","2021-11-16","2021-11-16","2021-11-16","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-10-26","2021-07-06","2021-11-02","2021-10-26","2021-11-02","2021-10-26","2021-07-13","2021-07-13","2022-01-04","2021-07-13","2021-07-13","2021-07-13","2020-08-18","2020-08-11","2021-11-02","2021-11-16","2021-11-02","2021-11-16","2021-11-02","2021-11-09","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2020-03-31","2020-04-21","2020-08-18","2021-02-11","2020-08-18","2021-09-07","2021-03-02","2021-09-07","2020-06-09","2021-11-02","2020-12-15","2021-11-02","2020-04-21","2020-04-21","2020-03-03","2021-11-02","2021-11-02","2021-10-26","2021-10-26","2020-04-09","2021-08-10","2020-04-09","2020-04-09","2020-04-09","2021-04-06","2021-02-02","2020-08-25","2021-05-04","2021-09-01","2021-05-18","2021-05-18","2021-08-10","2021-02-09","2020-08-11","2020-11-10","2021-06-22","2021-09-01","2021-11-09","2021-01-05","2020-12-15","2021-09-07","2020-11-10","2021-04-06","2021-04-06","2021-05-18","2021-02-02","2021-02-02","2021-02-02","2021-11-09","2021-11-09","2020-07-14","2020-08-18","2020-08-04","2021-02-11","2021-10-26","2021-03-16","2021-03-16"],"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":[["","50111043301","TRAZODONE","50MGTABLET","15","Select","Select",""],["","65862037505","ESCITALOPRAM","20MGTABLET","30","Select","Select",""],["","67877019905","AMLODIPINE","BESYLATE10MGTAB","30","Select","Select",""],["","50228014610","HYDROCHLOROTHIAZIDE","12.5MGCP","30","Select","Select",""],["","70377000612","ROSUVASTATIN","CALCIUM5MGTAB","30","Select","Select",""],["","70010049105","METFORMIN","HCLER500MGTABLET","30","Select","Select",""],["","49702023113","TRIUMEQ","600-50-300MGTABLET","30","Select","Select",""],["","68462043730","OLMESARTAN","MEDOXOMIL20MGTAB","30","Select","Select",""],["","143924920","AMOX-CLAV","875-125MGTABLET","20","Select","Select",""],["","68645055354","LISINOPRIL","20MGTABLET","30","Select","Select",""],["","66993001968","ALBUTEROL","HFA90MCGINHALER","18","Select","Select",""],["","173089310","TRELEGY","ELLIPTA200-62.5-25","60","Select","Select",""],["","67877021905","CEPHALEXIN","500MGCAPSULE","14","Select","Select",""],["","67877021660","CEFUROXIME","AXETIL500MGTAB","14","Select","Select",""],["","59148003813","REXULTI","2MGTABLET","30","Select","Select",""],["","42806071401","BENZONATATE","100MGCAPSULE","21","Select","Select",""],["","61958250101","BIKTARVY","50-200-25MGTABLET","30","Select","Select",""],["","173068220","VENTOLIN","HFA90MCGINHALER","18","Select","Select",""],["","406048410","ACETAMINOPHEN-COD","#3TABLET","12","Select","Select",""],["","42192033901","HYOSCYAMINE","0.125MGTABSL","9","Select","Select",""],["","57664037708","TRAMADOL","HCL50MGTABLET","8","Select","Select",""],["","52268001201","SUPREP","BOWELPREPKIT","354","Select","Select",""],["","69238110005","DOXYCYCLINE","HYCLATE100MGCAP","20","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":""}]}]}