{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Leah Norton","gend":1,"add":"227 Foster Rd","city":"Dalton","state":"GA","zip":30720,"dob":"1979-09-19","age":"","mstatus":"","insh":377204001,"cliId":"","pno":7062776121,"cno":"","email":"joseph.norton@gmail.com","ename":"","eno":"","pphy":"Brandon Smith","ppno":"","pcpadd":"1114 Professional Blvd","pcpcity":"Dalton","pcpstate":"GA","pcpzip":"","pcpcounty":"Dalton","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":["N39.0","I10","R06.02","M54.9","J45.909","R05","Z87.2","Z91.09","Z86.79","Z88.6","Z88.8","J32.9","J40","Z20.822","Z23","J02.9","R07.9","J06.9","M25.569","N64.4","R07.89","L20.81","R07.81","M54.59","R10.10","M54.5","J01.90","R94.31","Z82.49","I35.0"],"date":["2020-06-02","2021-10-12","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-06-02","2020-02-11","2020-02-11","2021-10-26","2021-05-04","2020-07-21","2020-04-21","2020-02-04","2020-02-04","2020-05-26","2020-06-02","2020-04-21","2020-02-11","2021-11-16","2021-04-20","2021-10-05","2020-02-11","2020-04-21","2020-04-21","2020-04-21"],"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":[["","50111078751","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","68645055654","LISINOPRIL-HCTZ","10-12.5MGTAB","30","Select","Select",""],["","65862007701","CIPROFLOXACIN","HCL500MGTAB","14","Select","Select",""],["","10702000709","CYCLOBENZAPRINE","10MGTABLET","15","Select","Select",""],["","29300018801","BISOPROLOL-HCTZ","5-6.25MGTAB","30","Select","Select",""],["","45802006535","TRIAMCINOLONE","0.005CREAM","15","Select","Select",""],["","54418425","DEXAMETHASONE","4MGTABLET","10","Select","Select",""],["","65162027250","SULFAMETHOXAZOLE-TMP","DSTABLET","14","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":""}]}]}