{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karen L Savage","gend":1,"add":"301 Garner Rd","city":"Cornelia","state":"GA","zip":30531,"dob":"1971-08-23","age":"","mstatus":"","insh":2471052001,"cliId":"","pno":7067789397,"cno":"","email":"karenandlane@yahoo.com","ename":"","eno":"","pphy":"THOMAS HATCHETT","ppno":"","pcpadd":"870A Austin Dr","pcpcity":"Demorest","pcpstate":"GA","pcpzip":"","pcpcounty":"Demorest","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":["N80.0","N72","Z20.828","Z12.31","J45.20","I10","E78.5","G47.00","R73.03","Z68.35","Z13.31","Z00.00","E78.1","F33.42","F41.9","Z90.710","F32.2","N92.0","E78.00","D25.9","N92.6","N89.8","N83.201","Z20.822","Z11.3","Z11.59","Z68.34","N92.1","Z30.432","R82.90"],"date":["2021-03-23","2021-03-23","2020-12-08","2021-06-08","2021-11-02","2021-11-02","2021-11-02","2021-05-04","2021-11-02","2021-11-02","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-05-04","2021-03-23","2020-10-06","2020-03-03","2021-03-23","2020-03-31","2020-10-13","2020-10-06","2021-04-20","2020-10-06","2021-04-13","2020-09-22","2020-12-08","2020-02-04","2020-09-22"],"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":[["","51991074890","DULOXETINE","HCLDR60MGCAP","30","Select","Select",""],["","50742061510","METOPROLOL","SUCCER25MGTAB","30","Select","Select",""],["","43598075201","BUPROPION","HCLSR150MGTABLET","30","Select","Select",""],["","378932132","WIXELA","250-50INHUB","60","Select","Select",""],["","591565810","CYCLOBENZAPRINE","10MGTABLET","90","Select","Select",""],["","65862096901","ESZOPICLONE","3MGTABLET","30","Select","Select",""],["","69452023420","PROGESTERONE","200MGCAPSULE","30","Select","Select",""],["","93083205","CLONAZEPAM","0.5MGTABLET","60","Select","Select",""],["","68180023209","FENOFIBRATE","160MGTABLET","30","Select","Select",""],["","70461042110","FLUCELVAX","QUAD2021-2022VIAL","0.5","Select","Select",""],["","93742698","MONTELUKAST","SOD10MGTABLET","30","Select","Select",""],["","228202750","ALPRAZOLAM","0.25MGTABLET","14","Select","Select",""],["","23155022801","ACYCLOVIR","800MGTABLET","28","Select","Select",""],["","58160084252","BOOSTRIX","TDAPVACCINESYRINGE","0.5","Select","Select",""],["","69918030130","TRANEXAMIC","ACID650MGTABLET","30","Select","Select",""],["","16714039102","CEFDINIR","300MGCAPSULE","14","Select","Select",""],["","59676058015","JANSSEN","COVID-19VACCINE(EUA)","0.5","Select","Select",""],["","93310905","AMOXICILLIN","500MGCAPSULE","31","Select","Select",""],["","47781022901","OXYCODON-ACETAMINOPHEN","7.5-325","10","Select","Select",""],["","43386035701","HYDROCODONE-ACETAMIN","7.5-325","16","Select","Select",""],["","51672126301","NYSTATIN-TRIAMCINOLONE","CREAM","15","Select","Select",""],["","47781030301","NITROFURANTOIN","MONO-MCR100MG","14","Select","Select",""],["","49281042050","FLUZONE","QUAD2020-2021SYRINGE","0.5","Select","Select",""],["","71930005552","ACETAMINOPHEN-COD","#3TABLET","21","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":""}]}]}