{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David Lindsey","gend":0,"add":"101 cub Traiil","city":"Sautee Nacoochee","state":"GA","zip":30571,"dob":"1972-02-23","age":"","mstatus":"","insh":4036277001,"cliId":"","pno":7065140327,"cno":"","email":"countryboylawnscaping@ymail.com","ename":"","eno":"","pphy":" ","ppno":"","pcpadd":"","pcpcity":"","pcpstate":"","pcpzip":"","pcpcounty":"","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":["S39.92X","S09.90X","S19.9XX","M54.2","M51.36","M54.5","M54.16","M50.30","M47.816","M53.3","Z79.891","Z51.81","F17.210","J44.9","F33.1","E55.9","R79.89","Z68.39","Z13.31","R55","Z13.89","M06.4","R45.851","M54.89","G43.909","G40.909","Z68.29","Z30.09","F11.20","F12.10","G89.29","E78.2","F17.200","Z98.1","M79.7","M15.0","R53.83","T39.1X2","G89.4","M06.9","F32.9","Z20.828","G47.19","M51.16","M50.11","M79.602","R29.898","F32.2","R06.02","R20.2","M54.59","Z79.899","M25.50","M51.9","J44.1","G43.809","G43.709","T42.6X2","T40.2X2","R06.4","Z68.27"],"date":["2021-10-13","2021-10-13","2021-10-13","2021-11-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-02-09","2021-01-12","2020-11-24","2020-11-24","2020-11-24","2020-11-24","2021-02-02","2020-12-29","2020-11-24","2020-11-17","2021-02-02","2021-01-12","2021-01-12","2020-02-11","2020-12-29","2020-12-15","2021-02-02","2021-01-12","2021-01-12","2021-01-12","2021-01-12","2021-01-12","2020-11-24","2020-11-24","2020-11-24","2021-01-05","2021-01-05","2021-01-05","2021-02-02","2021-01-05","2021-06-01","2020-08-18","2020-08-18","2020-08-18","2020-08-18","2021-01-12","2020-12-29","2021-11-09","2021-11-09","2021-01-19","2020-09-29","2020-09-29","2020-01-14","2021-01-05","2020-05-19","2021-02-02","2021-02-02","2020-12-15","2020-10-20"],"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":{"comment":"","sub":[["","16714033202","GABAPENTIN","800MGTABLET","90","Select","Select",""],["","406052301","OXYCODONE-ACETAMINOPHEN","10-325","120","Select","Select",""],["","93317431","ALBUTEROL","HFA90MCGINHALER","8.5","Select","Select",""],["","2143611","EMGALITY","120MG\/MLPEN","1","Select","Select",""],["","173088710","TRELEGY","ELLIPTA100-62.5-25","60","Select","Select",""],["","16714087403","ATORVASTATIN","10MGTABLET","30","Select","Select",""],["","65862019399","FLUOXETINE","HCL20MGCAPSULE","30","Select","Select",""],["","378037301","HYDROXYCHLOROQUINE","200MGTAB","60","Select","Select",""],["","93005801","TRAMADOL","HCL50MGTABLET","120","Select","Select",""],["","59310057922","PROAIR","HFA90MCGINHALER","8.5","Select","Select",""],["","406012510","HYDROCODONE-ACETAMIN","10-325MG","84","Select","Select",""],["","72205001390","PREGABALIN","75MGCAPSULE","60","Select","Select",""],["","50111045001","TRAZODONE","150MGTABLET","30","Select","Select",""],["","69097012212","TOPIRAMATE","25MGTABLET","60","Select","Select",""],["","228289103","DULOXETINE","HCLDR30MGCAP","30","Select","Select",""],["","23155050110","HYDROXYZINE","HCL25MGTABLET","60","Select","Select",""],["","54001825","PREDNISONE","20MGTABLET","10","Select","Select",""],["","69543038390","OLANZAPINE","10MGTABLET","30","Select","Select",""],["","31722072250","LEVOFLOXACIN","500MGTABLET","7","Select","Select",""],["","597010061","SPIRIVA","RESPIMAT2.5MCGINH","4","Select","Select",""],["","186037020","SYMBICORT","160-4.5MCGINHALER","10.2","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":""}]}]}