{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"CINDY KENNEY","gend":1,"add":"4111 Warren Rd","city":"Flowery Branch","state":"GA","zip":30542,"dob":"1957-02-07","age":"","mstatus":"","insh":2508716001,"cliId":"","pno":6787325816,"cno":"","email":"pamela.kenney@yahoo.com","ename":"","eno":"","pphy":"PAUL CERNY","ppno":"","pcpadd":"5875 Thompson Mill Rd,Suite 10","pcpcity":"Hoschton","pcpstate":"GA","pcpzip":"","pcpcounty":"Hoschton","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":["J18.1","R10.11","Z96.642","M25.652","R26.2","M16.12","I10","K21.9","Z87.891","Z01.818","Z86.19","Z79.899","Z11.59","J12.82","E87.6","R94.31","B19.20","M85.89","E78.5","E78.2","Z82.49","I65.29","Z68.24","M85.88","U07.1","Z01.419","N95.2","Z12.31","Z68.25","M25.562","M54.5","M99.53","M51.36","M16.11","Z00.00","F33.9","B18.2","R63.8","A09","M25.552","M16.0","Z20.822","R09.81","Z47.1","F41.9","G47.00"],"date":["2021-09-02","2021-09-02","2020-11-17","2020-09-08","2020-09-08","2020-09-08","2021-12-28","2021-08-31","2021-09-14","2021-08-31","2021-08-31","2021-08-31","2021-08-31","2021-09-28","2021-11-16","2021-12-28","2021-09-14","2020-12-01","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2020-12-01","2021-09-28","2020-10-27","2020-10-27","2020-12-08","2021-11-16","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2020-11-17","2021-06-01","2021-06-01","2021-06-01","2021-06-01","2021-08-31","2020-06-09","2020-06-09","2021-08-24","2021-08-24","2020-07-21","2020-05-12","2020-05-12"],"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":[["","69315090501","LORAZEPAM","1MGTABLET","30","Select","Select",""],["","65162062750","TRAMADOL","HCL50MGTABLET","28","Select","Select",""],["","93101042","MUPIROCIN","0.02OINTMENT","22","Select","Select",""],["","31722070090","LOSARTAN","POTASSIUM25MGTAB","30","Select","Select",""],["","69097015907","MELOXICAM","15MGTABLET","30","Select","Select",""],["","115151866","ESTRADIOL","0.0001CREAM","42.5","Select","Select",""],["","68645013054","FLUOXETINE","HCL20MGCAPSULE","30","Select","Select",""],["","10702001801","OXYCODONE","HCL5MGTABLET","50","Select","Select",""],["","59779013701","CVS","ASPIRINEC325MGTABLET","60","Select","Select",""],["","68462010530","ONDANSETRON","HCL4MGTABLET","10","Select","Select",""],["","70069042101","LATANOPROST","0.00005EYEDROPS","2.5","Select","Select",""],["","832532511","POTASSIUM","CLER20MEQTABLET","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":""}]}]}