{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Malinda Geers","gend":1,"add":"121 Settlement Rd","city":"Jasper","state":"GA","zip":30143,"dob":"1967-12-15","age":"","mstatus":"","insh":2009235001,"cliId":"","pno":4045762816,"cno":"","email":"geersm@gmail.com","ename":"","eno":"","pphy":"NANCY LEFEVER","ppno":"","pcpadd":"89 Clinic Rd","pcpcity":"Tate","pcpstate":"GA","pcpzip":"","pcpcounty":"Tate","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":["I10","E78.2","R74.8","E55.9","R79.82","E87.6","R16.1","R91.1","D48.5","R10.84","U07.1","Z13.31","R73.9","K29.70","K27.9","Z79.890","E66.9","R76.0","D89.89","R53.82","R11.2","Z88.0","Z85.41","R06.02","R20.2","R53.83","M25.50","M54.6","R11.0","R10.9","K76.0","Z79.899","Z86.16","K21.9","N95.1","N63.22","R07.9","M70.61","M70.62","N60.02","Z00.01","M25.551","Z13.6","N63.25","N63.0"],"date":["2021-12-28","2021-10-26","2021-04-27","2021-10-26","2021-10-26","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-05-04","2021-02-02","2021-02-02","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2020-09-01","2020-09-01","2020-09-08","2021-04-20","2021-04-20","2021-12-16","2021-08-03","2021-12-16","2021-12-16","2021-12-16","2021-04-20","2021-04-27","2021-04-20","2021-10-26","2020-08-11","2021-10-13","2020-08-18","2020-08-18","2021-02-02","2021-12-07","2020-09-29","2020-09-29","2020-04-09","2020-05-19","2020-05-19","2021-12-08","2021-11-23","2021-11-02"],"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":[["","781712254","ESTRADIOL","TDS0.0375MG\/DAY","4","Select","Select",""],["","29300012810","HYDROCHLOROTHIAZIDE","25MGTAB","30","Select","Select",""],["","62175013643","OMEPRAZOLE","DR40MGCAPSULE","30","Select","Select",""],["","64380073706","VITAMIN","D21.25MG(50,000UNIT)","4","Select","Select",""],["","50111078751","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","57237007730","ONDANSETRON","ODT4MGTABLET","10","Select","Select",""],["","378456105","POTASSIUM","CLER10MEQTABLET","30","Select","Select",""],["","29033000301","SUCRALFATE","1GMTABLET","30","Select","Select",""],["","57664037718","TRAMADOL","HCL50MGTABLET","10","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","59267100001","PFIZER","COVID-19VACCINE(EUA)","0.3","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":""}]}]}