{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tiffany M Parker","gend":1,"add":"35 Oracle Ct Unit 9230","city":"Ellijay","state":"GA","zip":30540,"dob":"1982-10-30","age":"","mstatus":"","insh":3776355001,"cliId":"","pno":8284478080,"cno":"","email":"tiffanymichellparker@hotmail.com","ename":"","eno":"","pphy":"Alana Kent","ppno":"","pcpadd":"14244 Highway 515 N,Suite 10","pcpcity":"Ellijay","pcpstate":"GA","pcpzip":"","pcpcounty":"Ellijay","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":["M25.50","M19.90","Z79.899","R68.2","M79.641","M79.642","J45.909","J31.0","R50.9","J45.20","J30.2","M19.042","M19.041","M19.072","J01.90","J20.9","R59.0","M19.071"],"date":["2021-05-11","2021-06-22","2021-05-25","2021-05-04","2021-07-06","2021-05-04","2020-11-10","2020-11-10","2021-05-25","2020-08-25","2020-08-25","2021-05-25","2021-05-25","2021-05-25","2021-11-02","2021-11-02","2021-06-08","2021-05-25"],"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":[["","574010770","CLOTRIMAZOLE","10MGTROCHE","35","Select","Select",""],["","29300022019","MONTELUKAST","SOD10MGTABLET","30","Select","Select",""],["","93681773","BUDESONIDE","1MG\/2MLINHSUSP","120","Select","Select",""],["","378827052","ALBUTEROL","SUL2.5MG\/3MLSOLN","375","Select","Select",""],["","527512170","NYSTATIN","100000UNIT\/MLSUSP","200","Select","Select",""],["","55111014512","FLUCONAZOLE","150MGTABLET","3","Select","Select",""],["","173085910","BREO","ELLIPTA100-25MCGINH","60","Select","Select",""],["","59762219803","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","68382005005","MELOXICAM","7.5MGTABLET","30","Select","Select",""],["","59746017509","PREDNISONE","20MGTABLET","10","Select","Select",""],["","173068220","VENTOLIN","HFA90MCGINHALER","18","Select","Select",""],["","42806031250","DOXYCYCLINE","HYCLATE100MGTAB","20","Select","Select",""],["","54418425","DEXAMETHASONE","4MGTABLET","11","Select","Select",""],["","65162067684","AZELASTINE","0.001(137MCG)SPRY","30","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":""}]}]}