{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Katie Boswell","gend":1,"add":"496 Piedmont Ct","city":"Gainesville","state":"GA","zip":30501,"dob":"1981-05-11","age":"","mstatus":"","insh":1737307003,"cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"CHRISTY WAGNER","ppno":"","pcpadd":"1856 Thompson Bridge Road Ste 14","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":["F41.1","E78.5","G43.109","Z13.31","R63.5","Z68.28","R06.02","R05","R09.1","L40.50","F41.9","Z00.00","Z23","Z68.27","R06.00","R07.9","Z20.828","R11.0","R10.32","R39.9","Z03.818","J02.9","R05.9","J06.9","H92.09","G43.909","J45.20","Z68.26","J45.909","L25.9","L29.9","J22","Z20.89","J20.9","R10.9","M54.5","K59.09","S50.12X","R20.2","S81.811","Z68.25","R50.9","J02.0","J01.90"],"date":["2021-08-24","2021-08-24","2021-10-19","2021-08-24","2021-08-24","2021-10-05","2020-05-19","2020-11-17","2020-05-19","2020-03-31","2020-03-31","2021-03-16","2021-03-16","2021-03-16","2020-03-24","2020-03-24","2020-12-15","2021-10-05","2021-03-16","2021-01-05","2020-12-08","2021-10-19","2021-11-16","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2020-10-13","2020-03-24","2021-06-08","2021-06-08","2020-05-19","2020-05-19","2020-04-21","2021-03-16","2021-04-20","2021-04-20","2020-12-15","2020-12-15","2020-06-30","2020-06-30","2020-04-21","2020-04-21","2021-11-16"],"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":[["","65862069730","VENLAFAXINE","HCLER150MGCAP","30","Select","Select",""],["","16714008210","HYDROXYZINE","HCL25MGTABLET","60","Select","Select",""],["","59746017509","PREDNISONE","20MGTABLET","21","Select","Select",""],["","23650110","UBRELVY","100MGTABLET","10","Select","Select",""],["","406012301","HYDROCODONE-ACETAMIN","5-325MG","8","Select","Select",""],["","69543038810","KETOROLAC","10MGTABLET","20","Select","Select",""],["","80777027399","MODERNA","COVID-19VACCINE(EUA)","0.5","Select","Select",""],["","66685100100","AMOX-CLAV","875-125MGTABLET","20","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","58657050016","CODEINE-GUAIFEN","10-100MG\/5ML","150","Select","Select",""],["","69452014430","BENZONATATE","200MGCAPSULE","20","Select","Select",""],["","68180016013","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","16571020150","DICLOFENAC","SODEC75MGTAB","60","Select","Select",""],["","55111018015","TIZANIDINE","HCL4MGTABLET","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":["",""]}},{"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":""}]}]}