{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Elise Rucker","gend":1,"add":"1403 Pebble Cove Ct","city":"Hiawassee","state":"GA","zip":30546,"dob":"1963-06-20","age":"","mstatus":"","insh":1820904001,"cliId":"","pno":7068357781,"cno":"","email":"eliserucker97@gmail.com","ename":"","eno":"","pphy":"Paula Boyle","ppno":"","pcpadd":"1155 Main St","pcpcity":"Young Harris","pcpstate":"GA","pcpzip":"","pcpcounty":"Young Harris","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":["Z95.2","Z79.01","R94.39","R53.83","Z95.1","I70.0","I27.20","I10","E78.5","J44.9","Z79.82","Z79.899","Z85.3","Z85.71","Z86.711","Z86.718","Z95.0","R07.89","Z45.018","I44.2","R91.8","R06.02","I38","R93.1","Z13.89","I25.10","R94.31","R07.2","I48.0","I49.5","Z45.010","C44.519","R92.2","C50.911","I25.118","I35.0","R09.89","I11.9","E78.2","I34.1","L85.3","E66.3","D48.5","I51.9","I34.2","I34.0","R00.0","Z00.00","C50.919","Z85.79","L90.5","E78.49","R06.09","C81.78","C85.90","M25.611","G89.29","M54.9","Z76.89","N95.1","Z68.30","L73.8","L82.1","I78.1","L81.6","E78.00","Z68.31","Z09","R73.01","E03.9","F41.9","C50.619","L01.01","Y84.2","D22.5","D18.00","K21.9","I31.3"],"date":["2022-01-06","2022-01-06","2021-02-02","2021-02-02","2021-11-02","2021-02-02","2021-03-09","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-02-02","2021-12-08","2020-02-11","2021-09-14","2021-12-08","2020-02-25","2020-02-25","2020-03-10","2020-03-10","2020-06-09","2021-06-22","2021-06-22","2021-06-22","2021-06-22","2021-06-22","2020-03-31","2021-02-23","2020-08-25","2020-08-25","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-03-09","2021-11-02","2021-11-02","2021-11-02","2021-08-24","2020-02-18","2020-02-18","2020-02-18","2020-08-04","2021-05-04","2020-08-04","2021-03-02","2020-03-24","2020-03-12","2020-03-12","2021-05-04","2021-01-19","2021-01-19","2021-01-19","2021-01-19","2020-07-28","2020-07-28","2020-10-20","2020-10-20","2020-10-20","2020-10-20","2020-02-04","2020-02-04","2022-01-06","2021-08-24","2021-08-24","2021-08-24","2020-02-18","2020-02-18","2020-02-18","2020-11-03","2020-11-03","2020-01-14","2020-01-14"],"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":[["","143993905","AMOXICILLIN","500MGCAPSULE","30","Select","Select",""],["","59762371809","TRIAZOLAM","0.25MGTABLET","3","Select","Select",""],["","54418425","DEXAMETHASONE","4MGTABLET","2","Select","Select",""],["","51672403201","WARFARIN","SODIUM5MGTABLET","17","Select","Select",""],["","63304001760","RANOLAZINE","ER500MGTABLET","60","Select","Select",""],["","68180071909","AMLODIPINE","BESYLATE2.5MGTAB","30","Select","Select",""],["","69097084805","ESCITALOPRAM","10MGTABLET","30","Select","Select",""],["","378001805","METOPROLOL","TARTRATE25MGTAB","60","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","63304069301","CLINDAMYCIN","HCL300MGCAPSULE","30","Select","Select",""],["","116200116","CHLORHEXIDINE","0.0012RINSE","473","Select","Select",""],["","69238115403","EZETIMIBE","10MGTABLET","30","Select","Select",""],["","65862029590","ROSUVASTATIN","CALCIUM20MGTAB","30","Select","Select",""],["","65162062711","TRAMADOL","HCL50MGTABLET","10","Select","Select",""],["","55111068205","IBU","400MGTABLET","14","Select","Select",""],["","70710122501","AMITRIPTYLINE","HCL10MGTAB","30","Select","Select",""],["","27808003602","HYDROCODONE-ACETAMIN","7.5-325","5","Select","Select",""],["","64764011907","COLCRYS","0.6MGTABLET","30","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":""}]}]}