{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"GLORIA MADDOX","gend":1,"add":"2876 Gaines Mill Rd","city":"Gainesville","state":"GA","zip":30507,"dob":"1957-09-09","age":"","mstatus":"","insh":3689749001,"cliId":"","pno":7706683594,"cno":"","email":"gmaddox537@gmail.com","ename":"","eno":"","pphy":"Ellen Sanders","ppno":"","pcpadd":"4222 Fairbanks Dr","pcpcity":"Oakwood","pcpstate":"GA","pcpzip":"","pcpcounty":"Oakwood","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":["C50.812","Z17.0","Z79.810","I10","Z80.3","Z90.13","Z90.710","R53.83","N64.4","Z68.27","Z13.31","Z68.28","Z00.00","Z13.89","Z23","Z11.59","L30.8","K21.9","K44.9","Z68.26","N63.20","Z85.3","E55.9","Z12.11","D12.2","D12.3","D12.5","R13.10","C50.212","D12.4","R92.8","L82.1","E78.00","D48.5","R13.14","Z12.12","K29.50","K22.2","Z98.82","K57.30","K64.1","Z78.0","Z13.820","K29.70"],"date":["2021-03-09","2021-10-05","2021-09-14","2021-10-12","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-02-09","2021-09-14","2021-03-09","2021-10-05","2021-10-05","2021-10-19","2020-10-20","2020-10-20","2021-10-12","2021-10-12","2021-10-05","2021-02-09","2021-09-28","2021-02-23","2021-07-27","2021-08-03","2021-08-03","2021-08-03","2021-06-22","2021-10-05","2021-08-03","2021-02-23","2021-03-02","2021-10-12","2021-02-11","2021-09-28","2021-06-22","2021-04-27","2021-04-27","2021-03-09","2021-07-27","2021-07-27","2020-10-20","2020-10-20","2021-04-20"],"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":[]},{"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":""}]}]}