{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Laura M Young","gend":1,"add":"5623 Pipsissewa Dr","city":"Flowery Branch","state":"GA","zip":30542,"dob":"1964-03-26","age":"","mstatus":"","insh":3832315002,"cliId":"","pno":"","cno":"","email":"","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":["M54.2","D33.3","M54.81","D36.10","G50.0","H91.22","Z68.25","Z00.00","R03.0","F98.8","K21.9","N95.9","E03.9","G43.809","Z68.28","G93.6","K44.9","E05.90","M06.9","Z79.899","Z11.59","Z68.29","R51.9","H92.02","R20.8","B96.5","J34.89","R51","H93.3X2","R13.14","J32.0","Z68.26","J33.9","J34.1","Z68.27","M06.4","M19.049","M47.897","R91.1","J98.11","M76.72","M25.572","M06.09","Z78.0","Z68.41","J32.8","S92.355","J32.1","J32.2","J32.3","F32.5","D23.39","L71.8","L81.4","L57.0","B07.8","J32.9","L73.9","D22.72","L23.9","L82.1","D48.5","R63.8","F32.9","J30.9","M26.629","G93.89","L53.8","G89.18","L73.8","Z20.822","R11.2","H04.123","H04.562","H52.4","H91.92","R20.0","Z01.419","Z12.31","B37.84","M47.812","E78.00","M05.79","Z20.828","Z13.1","Z23","J32.4","H90.5","N95.2","N95.1","R11.0","Z98.890","Z03.818","U07.1","J01.10","R06.02","L82.0"],"date":["2021-04-06","2021-02-11","2021-11-09","2021-11-09","2021-11-09","2021-11-09","2021-07-20","2021-10-12","2021-10-05","2022-01-04","2021-11-09","2021-10-05","2021-10-12","2021-10-05","2021-02-02","2021-04-21","2021-04-21","2021-04-21","2021-09-14","2021-10-19","2021-04-21","2021-10-12","2021-12-28","2021-06-15","2021-12-16","2021-06-15","2021-09-07","2020-10-06","2021-05-18","2021-05-18","2021-07-20","2020-03-24","2021-09-01","2021-09-07","2021-11-09","2021-10-19","2021-10-19","2021-10-19","2021-11-18","2021-11-18","2021-12-16","2021-12-16","2021-10-19","2021-07-06","2020-06-09","2021-12-28","2021-12-16","2021-12-28","2021-12-28","2021-12-28","2021-02-11","2021-08-17","2021-08-17","2021-08-17","2021-12-16","2021-12-16","2021-11-23","2020-12-01","2020-06-30","2020-06-30","2020-12-15","2020-06-30","2021-07-13","2020-10-13","2021-12-08","2020-12-15","2021-12-16","2021-12-16","2020-07-28","2020-12-15","2021-12-21","2020-07-28","2020-06-30","2020-06-30","2020-06-30","2020-05-12","2020-05-12","2021-02-02","2021-02-02","2021-12-08","2021-04-06","2021-10-12","2020-03-31","2021-01-12","2021-10-12","2021-11-16","2021-09-07","2020-05-12","2021-02-02","2021-02-02","2021-11-09","2021-04-06","2021-12-21","2021-01-19","2021-01-19","2021-01-19","2020-06-30"],"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":[["","378729553","ESTRADIOL-NORETH","1-0.5MGTAB","28","Select","Select",""],["","64764017530","DEXILANT","DR60MGCAPSULE","30","Select","Select",""],["","47781064310","LEVOTHYROXINE","50MCGTABLET","30","Select","Select",""],["","69050130","XELJANZ","XR11MGTABLET","30","Select","Select",""],["","67877021905","CEPHALEXIN","500MGCAPSULE","6","Select","Select",""],["","47335068788","PREGABALIN","50MGCAPSULE","30","Select","Select",""],["","50242014301","ACTEMRA","ACTPEN162MG\/0.9ML","3.6","Select","Select",""],["","527551537","DEXTROAMP-AMPHET","ER30MGCAP","30","Select","Select",""],["","51991074810","DULOXETINE","HCLDR60MGCAP","30","Select","Select",""],["","406048410","ACETAMINOPHEN-COD","#3TABLET","12","Select","Select",""],["","116200116","CHLORHEXIDINE","0.0012RINSE","473","Select","Select",""],["","16729048501","HYDROXYCHLOROQUINE","200MGTAB","60","Select","Select",""],["","59746017310","PREDNISONE","10MGTABLET","10","Select","Select",""],["","55111029309","SUMATRIPTAN","SUCC100MGTABLET","9","Select","Select",""],["","29300011510","TOPIRAMATE","25MGTABLET","120","Select","Select",""],["","50383094230","AZELASTINE","0.0015NASALSPRAY","30","Select","Select",""],["","61703035038","METHOTREXATE","50MG\/2MLVIAL","4","Select","Select",""],["","3218851","ORENCIA","CLICKJECT125MG\/ML","4","Select","Select",""],["","11534016503","FOLIC","ACID1MGTABLET","30","Select","Select",""],["","316022115","NYSTATIN","100000UNIT\/GMCREAM","15","Select","Select",""],["","61314012605","KETOROLAC","0.005OPHTHSOLUTION","5","Select","Select",""],["","45802009735","ESTRADIOL","0.0001CREAM","42.5","Select","Select",""],["","31722095005","OXYCODON-ACETAMINOPHEN","7.5-325","30","Select","Select",""],["","31722094905","OXYCODONE-ACETAMINOPHEN","5-325","14","Select","Select",""],["","68382004101","PROMETHAZINE","25MGTABLET","30","Select","Select",""],["","45802006435","TRIAMCINOLONE","0.001CREAM","15","Select","Select",""],["","69452017173","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","27808003603","HYDROCODONE-ACETAMIN","7.5-325","40","Select","Select",""],["","42571014405","CELECOXIB","200MGCAPSULE","30","Select","Select",""],["","65862039010","ONDANSETRON","ODT4MGTABLET","4","Select","Select",""],["","93317431","ALBUTEROL","HFA90MCGINHALER","8.5","Select","Select",""],["","65862001401","AMOXICILLIN","500MGTABLET","21","Select","Select",""],["","60505250301","LEFLUNOMIDE","20MGTABLET","30","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","55111012705","CIPROFLOXACIN","HCL500MGTAB","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":""}]}]}