{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Austin V Hannant","gend":1,"add":"455 Cantrell Rd","city":"Cleveland","state":"GA","zip":30528,"dob":"1985-09-18","age":"","mstatus":"","insh":1643318001,"cliId":"","pno":4043173094,"cno":"","email":"austinhannant85@gmail.com","ename":"","eno":"","pphy":"Wylie Newton","ppno":"","pcpadd":"2578 Helen Hwy","pcpcity":"Cleveland","pcpstate":"GA","pcpzip":"","pcpcounty":"Cleveland","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":["Z11.3","E03.9","Z68.32","R23.8","R07.9","R53.83","B18.2","F17.200","F12.20","R00.2","Z20.822","J10.1","R11.0","L50.9","R05","R06.02","F17.210","F15.90","J06.9","Z68.33","Z12.4","M54.6","M54.5","R73.09","Z68.34","D72.829","F15.10","F41.8","L02.91","R07.2","E66.9","F12.90","Z86.14","L73.9","F15.11","K08.89","K02.9","R76.8","R63.8","R50.9","J02.9","R94.31","L03.113","N30.00","Z00.00","Z23","Z12.31","Z80.3","R69","J02.0","R21"],"date":["2021-05-18","2021-10-05","2021-05-18","2021-09-07","2021-03-09","2021-09-07","2021-10-05","2021-10-05","2021-06-29","2021-05-25","2021-12-14","2021-12-14","2021-12-14","2021-08-24","2021-09-01","2021-08-24","2021-08-24","2021-08-24","2021-11-30","2021-10-05","2021-10-12","2021-07-27","2021-10-06","2021-08-03","2021-07-27","2021-09-07","2021-04-20","2021-10-05","2021-08-10","2021-05-25","2021-10-05","2021-03-23","2021-08-03","2021-09-07","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-11-30","2021-12-14","2021-03-09","2021-03-09","2021-03-09","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-10-05","2021-12-14","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":[["","16714072103","FLUOXETINE","HCL20MGCAPSULE","30","Select","Select",""],["","60432060416","PROMETHAZINE-DM","6.25-15MG\/5ML","118","Select","Select",""],["","33342025866","OSELTAMIVIR","PHOS75MGCAPSULE","10","Select","Select",""],["","68180096703","LEVOTHYROXINE","75MCGTABLET","30","Select","Select",""],["","65862042001","SULFAMETHOXAZOLE-TMP","DSTABLET","20","Select","Select",""],["","13668033005","TRAZODONE","50MGTABLET","30","Select","Select",""],["","65862017601","PENICILLIN","VK500MGTABLET","30","Select","Select",""],["","68462018022","MUPIROCIN","0.02OINTMENT","15","Select","Select",""],["","59267100001","PFIZER","COVID-19VACCINE(EUA)","0.3","Select","Select",""],["","57237007830","ONDANSETRON","ODT8MGTABLET","20","Select","Select",""],["","29300022701","METRONIDAZOLE","500MGTABLET","14","Select","Select",""],["","16714069211","FLUCONAZOLE","150MGTABLET","2","Select","Select",""],["","54001925","PREDNISONE","50MGTABLET","7","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","50111078710","AZITHROMYCIN","250MGTABLET","4","Select","Select",""],["","406012301","HYDROCODONE-ACETAMIN","5-325MG","10","Select","Select",""],["","68180012201","CEPHALEXIN","500MGCAPSULE","30","Select","Select",""],["","51224000160","BENZONATATE","200MGCAPSULE","30","Select","Select",""],["","14539067501","HYDROXYZINE","PAM50MGCAP","30","Select","Select",""],["","67877022210","GABAPENTIN","100MGCAPSULE","30","Select","Select",""],["","143928501","AMOXICILLIN","875MGTABLET","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":["",""],"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":""}]}]}