{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tiffany L Bulford","gend":1,"add":"3034 University Commons Drive","city":"Gainesville","state":"GA","zip":30504,"dob":"1973-10-11","age":"","mstatus":"","insh":394065001,"cliId":"","pno":6789897925,"cno":"","email":"tlbulford3@gmail.com","ename":"","eno":"","pphy":"Jameela Harper","ppno":"","pcpadd":"2578 Helen Hwy","pcpcity":"Cleveland","pcpstate":"GA","pcpzip":"","pcpcounty":"Cleveland","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":["M19.90","J45.909","I10","Z00.00","B00.9","F41.9","Z23","E55.9","N39.0","R30.0","J32.9","G43.011","R09.81","Z20.822","E53.8","D50.9","B02.9","Z20.2","R39.9","N76.0","M54.89","Z87.442","R06.02","Z87.410","M79.7","M41.9","M54.2","E61.1","R53.83","N20.0","J01.90","J30.9","R05","H92.01","J01.00","M50.322","R11.0","K62.5","R10.30","Z20.828","L26","B00.2","J40","R10.9","Z68.21","M54.5","L63.0","N92.0","L30.8","F41.1","K63.89","R19.7","R93.3","K21.0","K31.89","K92.1","J20.9","R68.83","F43.10","R94.6","R93.5","J02.9","J03.00","F90.2","R59.0","N80.3","Z68.20","M25.542","R51","R09.82","Z13.220","Z13.29","K52.9","R10.2","N94.6","G89.29","K59.00","R12","F33.2","F43.12","F60.5","K20.8","Z13.228","F90.9","Z12.31","L65.9","S29.012","Z01.419","Z12.4","K31.9","R21","N88.2","M54.6","L70.0","L64.9","L64.8"],"date":["2021-09-07","2021-09-07","2022-01-06","2021-10-26","2022-01-06","2022-01-06","2021-12-21","2022-01-06","2022-01-06","2022-01-06","2021-08-05","2022-01-06","2021-08-05","2021-12-16","2020-09-15","2022-01-06","2020-09-01","2020-09-01","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-10-26","2021-01-26","2021-09-28","2021-10-12","2022-01-06","2021-10-26","2021-07-13","2022-01-06","2021-07-13","2021-07-13","2022-01-06","2022-01-06","2020-12-15","2020-08-04","2020-08-04","2021-09-01","2021-10-13","2021-10-13","2021-08-17","2021-10-12","2021-10-26","2021-10-13","2021-09-28","2020-04-09","2021-01-26","2021-08-24","2020-09-01","2020-12-01","2020-12-01","2020-09-08","2020-09-08","2020-12-01","2021-10-13","2021-10-13","2021-09-01","2021-10-12","2020-08-18","2020-12-15","2021-10-20","2021-06-08","2021-10-20","2021-07-06","2020-03-24","2021-10-13","2020-09-15","2021-04-13","2021-09-14","2021-09-14","2020-08-04","2021-07-06","2021-07-06","2021-07-06","2021-02-09","2020-08-25","2021-08-24","2021-08-24","2021-08-24","2020-12-01","2020-08-11","2021-10-26","2021-10-26","2021-10-26","2020-02-25","2020-04-09","2020-04-09","2020-09-01","2020-11-24","2020-02-04","2020-02-11","2021-12-16","2021-12-16","2021-12-16"],"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":[["","65862018730","ONDANSETRON","HCL4MGTABLET","15","Select","Select",""],["","29300022701","METRONIDAZOLE","500MGTABLET","14","Select","Select",""],["","64980044145","CLOBETASOL","0.0005CREAM","45","Select","Select",""],["","54092054701","MOTEGRITY","2MGTABLET","30","Select","Select",""],["","43547037909","DULOXETINE","HCLDR20MGCAP","60","Select","Select",""],["","185067405","HYDROXYZINE","PAM25MGCAP","30","Select","Select",""],["","69315090510","LORAZEPAM","1MGTABLET","90","Select","Select",""],["","65649000330","TRULANCE","3MGTABLET","30","Select","Select",""],["","69452015120","VITAMIN","D21.25MG(50,000UNIT)","4","Select","Select",""],["","456120130","LINZESS","145MCGCAPSULE","30","Select","Select",""],["","23155002505","BUSPIRONE","HCL15MGTABLET","60","Select","Select",""],["","68001028103","DICLOFENAC","SODDR75MGTAB","60","Select","Select",""],["","66685100101","AMOX-CLAV","875-125MGTABLET","20","Select","Select",""],["","69452029120","ACYCLOVIR","800MGTABLET","21","Select","Select",""],["","62135062650","DOXYCYCLINE","HYCLATE100MGTAB","20","Select","Select",""],["","70954005930","PREDNISONE","10MGTABDOSEPACK","21","Select","Select",""],["","57664037718","TRAMADOL","HCL50MGTABLET","10","Select","Select",""],["","51862054005","BUTALB-ACETAMIN-CAFF","50-325-40","45","Select","Select",""],["","43386016106","MISOPROSTOL","200MCGTABLET","2","Select","Select",""],["","555097302","DEXTROAMP-AMPHETAMIN","20MGTAB","90","Select","Select",""],["","13668009690","PANTOPRAZOLE","SODDR20MGTAB","30","Select","Select",""],["","69452017173","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","52268001201","SUPREP","BOWELPREPKIT","354","Select","Select",""],["","43547040011","CYCLOBENZAPRINE","10MGTABLET","20","Select","Select",""],["","93083205","CLONAZEPAM","0.5MGTABLET","90","Select","Select",""],["","69117000801","CIPROFLOXACIN","HCL250MGTAB","14","Select","Select",""],["","70010075401","METHOCARBAMOL","500MGTABLET","14","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","60505025202","TIZANIDINE","HCL4MGTABLET","30","Select","Select",""],["","42571025201","CLINDAMYCIN","HCL300MGCAPSULE","14","Select","Select",""],["","406048401","ACETAMINOPHEN-COD","#3TABLET","30","Select","Select",""],["","143122701","DICYCLOMINE","20MGTABLET","20","Select","Select",""],["","51672139400","TRETINOIN","0.0005CREAM","20","Select","Select",""],["","49483060450","IBUPROFEN","800MGTABLET","16","Select","Select",""],["","67877021905","CEPHALEXIN","500MGCAPSULE","20","Select","Select",""],["","68382005105","MELOXICAM","15MGTABLET","15","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":""}]}]}