{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Greg Lovell","gend":0,"add":"537 Old Highway 5","city":"Blue Ridge","state":"GA","zip":30513,"dob":"1966-07-19","age":"","mstatus":"","insh":2101101001,"cliId":"","pno":7069367570,"cno":"","email":"greglovell2006@yahoo.com","ename":"","eno":"","pphy":"Neal Tah","ppno":"","pcpadd":"4799 Blue Ridge Drive,Suite 10","pcpcity":"Blue Ridge","pcpstate":"GA","pcpzip":"","pcpcounty":"Blue Ridge","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":["K74.69","F17.220","Z20.822","K70.31","I50.30","I50.31","K72.90","R41.82","Z88.5","D64.9","M62.81","D37.4","K57.30","K64.8","K29.70","K29.80","M17.11","M17.12","M75.41","Z71.9","Z28.21","K74.60","Z79.899","Z12.5","I10","E78.5","M25.511","F32.9","R11.0","K59.00","K21.9","L40.9","F43.23","F33.0","Z23","M25.561","Z66","K76.6","E46","E87.1","N17.9","Z68.41","K70.40","I11.0","D53.9","E11.43","E53.8","E66.01","E83.39","E83.42","E87.6","F10.10","F12.90","G25.0","K31.84","R19.7","K70.9","R07.2","R06.02","R60.1","M75.101","F10.20","K31.89","Z12.11","D12.0","D12.2","D12.4","F41.1","G62.9","K70.30","D50.9","Z87.19","K75.89","K63.5","K25.9","F22","M17.0","E61.2","R94.5","M79.89","R60.0","J18.9","K76.89","K76.0","R68.89","R26.2","E87.70","L29.9","I95.1","R25.1","H25.13","E11.9","J30.9","L98.9","K21.00","R89.9","L40.8","L40.0","L82.1","D22.5","R53.83","L40.50","M17.9","B35.4","R74.8","R74.0","G47.00","R25.2","K72.00","R18.8","R26.9","R53.1","R07.9","F43.10","L40.52","K76.9","H00.025","M67.431","F41.9","L29.8","G89.18","L28.2","Z11.52","K21.0","Z00.00","F33.1","Z01.00","L21.8","J30.89","M25.569"],"date":["2021-12-07","2021-12-16","2022-01-06","2020-03-24","2020-03-24","2020-03-24","2020-03-24","2021-12-14","2021-11-30","2020-10-06","2020-04-09","2020-05-05","2020-12-01","2020-05-05","2020-05-05","2020-05-05","2021-04-20","2021-04-20","2021-05-18","2021-02-23","2021-02-23","2021-12-28","2021-09-21","2021-03-30","2021-06-08","2021-09-21","2021-08-10","2021-09-28","2021-09-28","2020-07-14","2021-09-28","2021-09-28","2021-06-29","2021-06-29","2021-07-27","2021-09-22","2020-03-12","2020-04-09","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-04-09","2020-03-12","2020-03-12","2020-09-22","2020-03-12","2021-09-28","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-12","2020-03-03","2020-03-24","2020-03-03","2021-06-08","2021-12-28","2020-06-30","2020-12-01","2020-06-30","2020-06-30","2020-06-30","2021-05-04","2021-05-04","2021-09-28","2020-04-09","2021-12-28","2021-12-07","2020-12-01","2020-12-01","2022-01-06","2021-09-14","2020-08-11","2020-10-06","2020-03-24","2020-04-09","2020-04-09","2021-12-07","2021-12-07","2020-04-09","2020-03-24","2020-03-03","2020-09-01","2020-05-12","2020-04-09","2021-08-24","2021-08-24","2020-11-03","2020-11-03","2020-11-03","2020-11-03","2021-03-09","2021-10-12","2021-10-05","2021-10-05","2020-04-09","2021-03-30","2021-08-05","2021-10-05","2020-09-01","2020-03-24","2020-03-24","2020-03-24","2020-03-24","2020-03-24","2020-03-24","2022-01-06","2021-12-14","2021-08-24","2020-03-12","2020-03-12","2020-08-11","2020-10-06","2021-06-08","2020-07-21","2021-05-25","2021-09-28","2021-09-28","2020-09-01","2021-03-30","2021-11-30","2021-06-08","2020-11-03","2020-11-03","2020-03-03"],"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":[["","16729013616","CLONAZEPAM","0.5MGTABLET","60","Select","Select",""],["","50222030260","ENSTILAR","0.005%-0.064%FOAM","60","Select","Select",""],["","72205001390","PREGABALIN","75MGCAPSULE","60","Select","Select",""],["","51672127401","BETAMETHASONE","DP0.0005CRM","45","Select","Select",""],["","55513013760","OTEZLA","30MGTABLET","60","Select","Select",""],["","472080460","DESONIDE","0.0005CREAM","60","Select","Select",""],["","62332002431","FLUOXETINE","HCL40MGCAPSULE","30","Select","Select",""],["","55111015430","ONDANSETRON","HCL8MGTABLET","24","Select","Select",""],["","59746021601","SPIRONOLACTONE","25MGTABLET","15","Select","Select",""],["","574402435","ERYTHROMYCIN","0.005EYEOINTMENT","3.5","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","67877025145","TRIAMCINOLONE","0.001CREAM","454","Select","Select",""],["","51672129803","KETOCONAZOLE","0.02CREAM","60","Select","Select",""],["","57237001930","DULOXETINE","HCLDR60MGCAP","30","Select","Select",""],["","58468009003","SYNVISC-ONE","SYRINGE","12","Select","Select",""],["","50383077916","LACTULOSE","10GM\/15MLSOLUTION","500","Select","Select",""],["","65162062750","TRAMADOL","HCL50MGTABLET","15","Select","Select",""],["","16714008210","HYDROXYZINE","HCL25MGTABLET","30","Select","Select",""],["","43547040211","FUROSEMIDE","40MGTABLET","30","Select","Select",""],["","31722099601","HYDROCODONE-ACETAMIN","5-325MG","40","Select","Select",""],["","42858000201","OXYCODONE","HCL10MGTABLET","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":["",""],"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":""}]}]}