{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kayla A Garbutt","gend":1,"add":"2596 Oconee Cir","city":"Gainesville","state":"GA","zip":30507,"dob":"1994-11-30","age":"","mstatus":"","insh":1337190001,"cliId":"","pno":7706884440,"cno":"","email":"kaylagarbutt@yahoo.com","ename":"","eno":"","pphy":"Marti Gibbs","ppno":"","pcpadd":"725 Jesse Jewell Parkway SE","pcpcity":"Gainesville","pcpstate":"GA","pcpzip":"","pcpcounty":"Gainesville","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":["R00.1","R51","R11.0","G89.29","R07.9","R68.83","H53.8","H55.00","I10","F43.12","D50.9","R00.2","R42","E55.9","R53.82","R65.11","H70.11","R65.10","D84.9","Z51.81","J30.1","R23.8","E53.8","L65.9","Z23","Z68.27","N75.0","N89.8","Z68.28","R10.2","Z01.419","Z12.4","Z11.3","Z00.00","R61","Z13.31","R63.8","Z68.29","H66.001","H61.21","F41.1","N94.0","G43.009","K21.9","F32.0","F33.1","F43.10","G47.9","Z79.899","J32.9","M79.7","R06.02","J30.5","R30.0","E16.2","R55","E04.9","E04.1","R07.81","W19.XXX","M25.572","H70.90","Z22.322","A49.02","R10.9","R87.610","G47.33","R06.83","Z11.59","Z20.828","M25.549","R79.89","R03.0","I15.9","S29.9XX","R63.0","H65.01","T14.8XX","Z68.26","I34.9","L30.9","S99.912","H69.81","H74.03","G43.719","I95.2","J45.20","H69.83","B99.9"],"date":["2020-03-03","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2021-10-12","2022-01-06","2021-04-13","2021-05-04","2021-05-04","2021-05-18","2021-09-28","2020-04-09","2020-04-09","2020-04-09","2021-11-23","2021-05-11","2021-08-24","2020-04-09","2021-10-12","2021-04-13","2021-11-23","2021-06-22","2020-08-04","2020-07-14","2020-07-14","2020-08-04","2020-11-24","2020-11-24","2020-11-24","2021-11-23","2021-11-23","2021-11-23","2021-11-23","2021-12-14","2021-11-23","2021-11-23","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-03-02","2021-05-18","2021-05-18","2021-06-22","2021-05-18","2021-09-22","2021-04-13","2021-09-22","2021-04-13","2020-07-21","2020-07-21","2021-02-11","2021-04-13","2021-04-13","2020-11-03","2020-11-03","2020-11-03","2020-02-04","2020-02-04","2020-02-04","2020-02-18","2020-11-24","2021-07-13","2021-08-24","2021-11-23","2020-12-08","2021-05-18","2021-05-18","2021-06-22","2021-04-13","2020-08-25","2020-06-09","2020-12-22","2020-12-22","2020-12-22","2020-05-05","2021-02-11","2020-08-25","2020-02-18","2020-02-18","2021-12-14","2020-02-25","2021-08-24","2021-08-24","2021-08-24"],"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":[["","93078710","ATENOLOL","25MGTABLET","30","Select","Select",""],["","42192033901","HYOSCYAMINE","0.125MGTABSL","90","Select","Select",""],["","68180035302","SERTRALINE","HCL100MGTABLET","30","Select","Select",""],["","378668999","PANTOPRAZOLE","SODDR40MGTAB","30","Select","Select",""],["","68180098003","LISINOPRIL","10MGTABLET","30","Select","Select",""],["","59651039001","BUSPIRONE","HCL7.5MGTABLET","60","Select","Select",""],["","68180031909","BUPROPION","HCLXL150MGTABLET","30","Select","Select",""],["","60505252603","MODAFINIL","100MGTABLET","30","Select","Select",""],["","69452015120","VITAMIN","D21.25MG(50,000UNIT)","4","Select","Select",""],["","65862001705","AMOXICILLIN","500MGCAPSULE","20","Select","Select",""],["","68462015305","TOPIRAMATE","50MGTABLET","30","Select","Select",""],["","713075915","BETAMETHASONE","DP0.0005CRM","15","Select","Select",""],["","93314705","CEPHALEXIN","500MGCAPSULE","20","Select","Select",""],["","27241009903","DULOXETINE","HCLDR60MGCAP","30","Select","Select",""],["","185094098","CHOLESTYRAMINE","PACKET","60","Select","Select",""],["","57237000511","FLUCONAZOLE","150MGTABLET","2","Select","Select",""],["","57237007710","ONDANSETRON","ODT4MGTABLET","20","Select","Select",""],["","55111012701","CIPROFLOXACIN","HCL500MGTAB","14","Select","Select",""],["","68180071160","CEFDINIR","300MGCAPSULE","30","Select","Select",""],["","50742065601","CARISOPRODOL","350MGTABLET","60","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}