{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Catherine Satterfield","gend":1,"add":"116 Bailie Ln","city":"Chatsworth","state":"GA","zip":30705,"dob":"1957-01-19","age":"","mstatus":"","insh":1001272001,"cliId":"","pno":6787674016,"cno":"","email":"nanacathy5782@yahoo.com","ename":"","eno":"","pphy":"Kerry Neises","ppno":"","pcpadd":"1107 Memorial Dr,Suite 30","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":["R06.02","E11.9","I10","E03.9","F32.9","Z79.02","Z79.4","Z20.822","Z79.84","J96.01","U07.1","G25.81","I25.10","M47.816","M50.90","I63.9","K21.9","E11.319","G47.33","G62.9","Z79.891","Z13.228","H40.053","H25.041","R07.9","E11.65","M51.9","M15.9","R53.83","G89.29","R00.1","U09.9","R06.09","E78.5","I11.0","I50.9","F32.A","E11.40","I65.23","E66.01","Z68.33","Z86.73","Z79.899","R07.2","I50.1","H52.01","H52.12","H52.223","H52.4","R00.2","R07.89","H40.023","H25.13","I49.3","M54.5","M43.06","J12.82","E11.42","M19.90","M25.561","E11.649","Z23","S60.229","M79.673","L84","M20.11","M20.12","Z68.35","E11.8","J18.9","M17.12","M17.11","E11.21","I15.9","I51.7","I51.9","R42","M79.676","R73.09","Z68.37","J98.11","I49.1","I47.1","F43.20","R07.0","J02.8","R09.02","R05","R19.7","R51.9","R06.00","I47.2","R10.84","K22.2","R94.31","J32.0","H92.03","I49.8","J02.9","R51","K76.0","I77.9","I49.9","I37.1","I50.32","R07.1","R13.10","J12.81"],"date":["2021-11-16","2021-12-08","2021-11-30","2021-11-02","2021-10-26","2021-11-02","2021-12-08","2021-11-16","2021-10-26","2021-05-25","2021-07-06","2021-05-25","2021-11-02","2020-04-09","2021-11-23","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-08-03","2021-06-29","2021-11-16","2021-10-19","2021-11-23","2021-11-23","2021-11-23","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-02","2021-11-09","2021-11-09","2021-08-03","2021-08-03","2021-08-03","2021-06-01","2021-11-30","2021-11-02","2021-12-08","2021-12-08","2021-12-21","2021-04-27","2021-10-05","2021-05-25","2021-05-25","2021-09-21","2021-10-05","2021-08-10","2021-10-19","2021-09-21","2021-09-21","2020-09-08","2020-09-08","2020-09-08","2020-05-19","2021-11-16","2021-05-11","2021-08-03","2021-08-03","2020-04-09","2020-04-09","2020-05-12","2020-05-12","2020-11-10","2020-11-10","2020-09-22","2020-09-22","2021-10-26","2020-07-14","2020-07-14","2021-10-05","2021-08-03","2021-08-03","2021-03-02","2021-02-09","2021-02-09","2021-02-09","2021-11-02","2021-11-23","2021-10-19","2021-10-19","2021-10-26","2020-08-18","2020-08-18","2020-02-11","2020-08-11","2020-08-11","2021-10-12","2021-11-09","2021-10-19","2021-11-09","2021-11-23","2020-04-21","2021-10-05","2021-02-23"],"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":[["","169255013","TRESIBA","FLEXTOUCH200UNIT\/ML","18","Select","Select",""],["","65862035705","CLOPIDOGREL","75MGTABLET","30","Select","Select",""],["","62332003331","ROPINIROLE","HCL2MGTABLET","30","Select","Select",""],["","781163501","ISOSORBIDE","DINITRATE5MGTAB","60","Select","Select",""],["","781518392","LEVOTHYROXINE","88MCGTABLET","30","Select","Select",""],["","16714033202","GABAPENTIN","800MGTABLET","120","Select","Select",""],["","60505017009","PRAVASTATIN","SODIUM40MGTAB","30","Select","Select",""],["","62175061746","PANTOPRAZOLE","SODDR40MGTAB","30","Select","Select",""],["","51991029205","OXCARBAZEPINE","150MGTABLET","60","Select","Select",""],["","456140530","BYSTOLIC","5MGTABLET","30","Select","Select",""],["","53746064101","FLECAINIDE","ACETATE50MGTAB","60","Select","Select",""],["","43547035311","LISINOPRIL","10MGTABLET","30","Select","Select",""],["","54350049","LIDOCAINE","0.02VISCOUSSOLN","120","Select","Select",""],["","59762033302","LATANOPROST","0.00005EYEDROPS","2.5","Select","Select",""],["","597015330","JARDIANCE","25MGTABLET","30","Select","Select",""],["","378875006","DICLOFENAC","SODIUM0.01GEL","500","Select","Select",""],["","70010049105","METFORMIN","HCLER500MGTABLET","60","Select","Select",""],["","60758080105","TIMOLOL","MALEATE0.005EYEDROPS","5","Select","Select",""],["","13668001105","CITALOPRAM","HBR40MGTABLET","30","Select","Select",""],["","378415105","TRAMADOL","HCL50MGTABLET","120","Select","Select",""],["","69097081715","TOPIRAMATE","50MGTABLET","46","Select","Select",""],["","42806071405","BENZONATATE","100MGCAPSULE","20","Select","Select",""],["","781808926","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","43386048024","ORPHENADRINE","ER100MGTABLET","60","Select","Select",""],["","55111018010","TIZANIDINE","HCL4MGTABLET","45","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","72065013112","GVOKE","PFS2-PK1MG\/0.2MLSYR","0.4","Select","Select",""],["","2879959","HUMALOG","100UNIT\/MLKWIKPEN","15","Select","Select",""],["","781107810","ATENOLOL","25MGTABLET","30","Select","Select",""],["","70010077005","METHOCARBAMOL","750MGTABLET","90","Select","Select",""],["","42571014726","DORZOLAMIDE-TIMOLOL","EYEDROPS","10","Select","Select",""],["","378020810","FUROSEMIDE","20MGTABLET","20","Select","Select",""],["","603533715","PREDNISONE","5MGTABDOSEPACK","21","Select","Select",""],["","93317431","ALBUTEROL","HFA90MCGINHALER","8.5","Select","Select",""],["","54418625","DEXAMETHASONE","6MGTABLET","10","Select","Select",""],["","2143380","TRULICITY","0.75MG\/0.5MLPEN","2","Select","Select",""],["","68462018022","MUPIROCIN","0.02OINTMENT","22","Select","Select",""],["","597008717","ATROVENT","17MCGHFAINHALER","12.9","Select","Select",""],["","76385011050","CARVEDILOL","3.125MGTABLET","60","Select","Select",""],["","16714007106","BACLOFEN","10MGTABLET","90","Select","Select",""],["","67405060301","FLUCONAZOLE","150MGTABLET","1","Select","Select",""],["","42806031205","DOXYCYCLINE","HYCLATE100MGTAB","14","Select","Select",""],["","24208063562","NEOMYCIN-POLYMYXIN-HC","EARSUSP","10","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":""}]}]}