{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"RICHARD M EDWARDS","gend":0,"currentgend":"","add":"1011 State Street","city":"Augusta","state":"KS","zip":"67010","dob":"1951-01-30","age":"","mstatus":"","insh":"2QQ6DJ3FH56","cliId":"","pno":"3343226057","cno":"","email":"","ename":"","eno":"","pphy":"SCOTT HARDER","ppno":3167757500,"pcpadd":"2820 OHIO ST","pcpcity":"AUGUSTA","pcpstate":"KS","pcpzip":"67010-2361","pcpcounty":"","pcpid":"","pcpname":"HARDER FAMILY PRACTICE","plan":"BCBSKS","program":"Medicare","lob":"006","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1011 State Street","madd2":"","madd3":"","mcity":"Augusta","mstate":"KS","mzip":"67010","pcpfaxno":"","pcpnpi":1932166154,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2QQ6DJ3FH56","medicaidid":"2QQ6DJ3FH56","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":[]},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","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":[]}]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","Hydroco\/Apap Tab 10-325Mg","","","Select","Select",""],["","","Flecainide Tab","50 MG","","Select","Select",""],["","","Lorazepam Tab","1 MG","","Select","Select",""],["","","Losartan Pot Tab","50 MG","","Select","Select",""],["","","Methylpred Tab","4 MG","","Select","Select",""],["","","Chlorthalid Tab","50 MG","","Select","Select",""],["","","Polymyxin B\/ Sol Trimethp","","","Select","Select",""],["","","Terbinafine Tab","250 MG","","Select","Select",""],["","","Hydroco\/Apap Tab 7.5-325","","","Select","Select",""],["","","Furosemide Tab","40 MG","","Select","Select",""],["","","Trazodone Tab","100 MG","","Select","Select",""],["","","Latanoprost Sol 0.005%","","","Select","Select",""],["","","Tizanidine Tab","4 MG","","Select","Select",""],["","","Baclofen Tab","10 MG","","Select","Select",""],["","","Pot Cl Micro Tab","20 MEQ","","Select","Select",""],["","","Pot Chloride Tab","20 MEQ","","Select","Select",""],["","","Carvedilol Tab","12.5 MG","","Select","Select",""],["","","Metoprol Suc Tab","25 MG","","Select","Select",""],["","","Bupropion Tab","300 MG","","Select","Select",""],["","","Dorzol\/Timol Sol 2-0.5%Op","","","Select","Select",""],["","","Zolpidem Tab","5 MG","","Select","Select",""],["","","Tamsulosin Cap","0.4 MG","","Select","Select",""],["","","Hydralazine Tab","100 MG","","Select","Select",""],["","","Eliquis Tab","5 MG","","Select","Select",""],["","","Amox\/K Clav Tab 875-125","","","Select","Select",""],["","","Atorvastatin Tab","20 MG","","Select","Select",""],["","","Amiodarone Tab","200 MG","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of 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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":""}]}]}