{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Harvey Yates","gend":0,"add":"2033 Tolbert Town Rd","city":"Rockmart","state":"GA","zip":30153,"dob":"1957-03-09","age":"","mstatus":"","insh":2513991001,"cliId":"","pno":6789888678,"cno":"","email":"deonnemartin56@att.net","ename":"","eno":"","pphy":"LYNDSAY CLARONI","ppno":"","pcpadd":"60 Knox Mountain Rd","pcpcity":"Rockmart","pcpstate":"GA","pcpzip":"","pcpcounty":"Rockmart","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":["I12.9","N18.9","K21.9","F41.9","N27.0","J44.9","E78.5","M43.12","M50.122","F17.210","M54.12","G89.4","Z79.891","N18.2","M50.30","M48.02","R51.9","G89.29","Z01.818","I10","Z01.810","N28.81","J30.9","M50.90","Z98.1","M65.351","J34.2","J30.89","H60.543","J32.4","J38.4","J38.3","M96.1","M79.643","M54.2","J01.01","J34.3","M47.812","J32.9","M54.81","M79.18","R07.9"],"date":["2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-10-06","2022-01-06","2022-01-06","2021-11-30","2021-11-23","2022-01-04","2021-06-22","2022-01-04","2021-11-30","2021-11-30","2021-10-26","2021-11-30","2021-11-30","2021-11-30","2021-12-08","2021-11-30","2021-07-13","2021-06-15","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2022-01-06","2022-01-06","2021-11-18","2021-05-18","2021-06-15","2021-12-08","2021-07-13","2021-10-26","2021-10-26","2021-11-09"],"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":[["","62175013643","OMEPRAZOLE","DR40MGCAPSULE","30","Select","Select",""],["","29300013005","HYDROCHLOROTHIAZIDE","12.5MGCP","30","Select","Select",""],["","16714087403","ATORVASTATIN","10MGTABLET","30","Select","Select",""],["","16714072204","FLUOXETINE","HCL40MGCAPSULE","30","Select","Select",""],["","55111018010","TIZANIDINE","HCL4MGTABLET","30","Select","Select",""],["","186037020","SYMBICORT","160-4.5MCGINHALER","10.2","Select","Select",""],["","80777027398","MODERNA","COVID-19VACCINE(EUA)","0.2","Select","Select",""],["","45802005535","TRIAMCINOLONE","0.001OINTMENT","15","Select","Select",""],["","68180096301","ALBUTEROL","HFA90MCGINHALER","8.5","Select","Select",""],["","49281072110","FLUBLOK","QUAD2021-2022SYRINGE","0.5","Select","Select",""],["","58160082311","SHINGRIX","VIALKIT","1","Select","Select",""],["","57237002901","AMOXICILLIN","875MGTABLET","20","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4MGDOSEPK","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":""}]}]}