{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"DOUGLAS G PATTERSON","gend":0,"currentgend":"","add":"207 Franklin St","city":"MC LOUTH","state":"KS","zip":"66054","dob":"1949-07-03","age":"","mstatus":"","insh":"3GE0NY2YK29","cliId":"","pno":"7855512350","cno":"","email":"","ename":"","eno":"","pphy":"MELISSA NORRIS","ppno":"7855055400","pcpadd":"1112 W 6TH ST","pcpcity":"LAWRENCE","pcpstate":"KS","pcpzip":"66086-5443","pcpcounty":"","pcpid":"","pcpname":"LAWRENCE WOUND HEALING PHYSICIANS","plan":"BCBSKS","program":"Medicare","lob":"012","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO Box 155","madd2":"","madd3":"","mcity":"Mc Louth","mstate":"KS","mzip":"66054","pcpfaxno":"","pcpnpi":1003554650,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3GE0NY2YK29","medicaidid":"3GE0NY2YK29","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"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":[["","","Mounjaro Inj 12.5\/0.5","","","Select","Select",""],["","","Losartan Pot Tab","50 MG","","Select","Select",""],["","","Cephalexin Cap","500 MG","","Select","Select",""],["","","Pregabalin Cap","150 MG","","Select","Select",""],["","","Carvedilol Tab","25 MG","","Select","Select",""],["","","Tramadol Hcl Tab","50 MG","","Select","Select",""],["","","Furosemide Tab","40 MG","","Select","Select",""],["","","Pot Chloride Tab","20 MEQ","","Select","Select",""],["","","Pot Cl Micro Tab","20 MEQ","","Select","Select",""],["","","Duloxetine Cap","60 MG","","Select","Select",""],["","","Mounjaro Inj","5 MG","","Select","Select",""],["","","Gabapentin Cap","300 MG","","Select","Select",""],["","","Metoprol Suc Tab","25 MG","","Select","Select",""],["","","Mounjaro Inj 7.5\/0.5","","","Select","Select",""],["","","Prednisone Tab","20 MG","","Select","Select",""],["","","Mounjaro Inj 2.5\/0.5","","","Select","Select",""],["","","Levofloxacin Tab","500 MG","","Select","Select",""],["","","Spironolact Tab","25 MG","","Select","Select",""],["","","Atorvastatin Tab","40 MG","","Select","Select",""],["","","Omeprazole Cap","40 MG","","Select","Select",""],["","","Eliquis Tab","5 MG","","Select","Select",""],["","","Ondansetron Tab","4 MG","","Select","Select",""],["","","Amox\/K Clav Tab 875-125","","","Select","Select",""],["","","Meloxicam Tab","15 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":""}]}]}