{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard J Cornwell","gend":0,"add":"182 Morning Side Dr","city":"Blairsville","state":"GA","zip":30512,"dob":"1979-10-15","age":"","mstatus":"","insh":4044142002,"cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"TIFFANY BORING","ppno":"","pcpadd":"104 Grand Avenue,N","pcpcity":"Copperhill","pcpstate":"TN","pcpzip":"","pcpcounty":"Copperhill","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":["R10.13","R07.89","R63.4","E66.3","I20.8","R20.0","R00.0","E66.9","K21.9","Z68.27","Z82.49","Z87.891","R07.9","Z12.5","Z00.00","Z13.220","R20.2","R55","M54.9","L20.9","Z79.899","Z82.3","Z68.26","M54.12","K44.9","I20.0","M79.602","M54.2","F45.8","R10.10","R07.2","K22.70","Z68.28","R11.0","E78.2","R00.2","R53.83","R06.00","K29.60","F41.9","R25.1","G93.89","G91.9","G93.6","R06.02","R61","R21","R42","M25.511","K29.00","R93.89","Z68.30","K22.4","M50.121","R63.8","L20.89","L81.8","M25.512","R13.10","K20.80","F41.0","J98.11"],"date":["2020-04-09","2021-11-09","2020-04-09","2021-05-25","2020-05-05","2020-05-05","2021-09-07","2020-05-05","2021-09-14","2020-05-05","2020-06-09","2021-08-17","2021-10-26","2020-12-29","2020-12-29","2020-12-29","2020-05-12","2020-05-12","2020-03-12","2020-03-12","2020-04-09","2020-03-12","2021-11-09","2020-07-28","2021-10-26","2020-05-05","2020-04-09","2021-10-26","2020-05-12","2020-04-09","2020-05-12","2021-10-20","2021-05-25","2020-03-31","2021-07-06","2021-11-09","2021-08-24","2020-04-09","2021-11-02","2021-08-24","2020-03-31","2020-04-21","2020-04-21","2020-04-21","2020-04-21","2020-03-10","2020-07-07","2021-08-24","2021-11-02","2021-10-20","2020-04-28","2020-03-10","2021-09-14","2020-06-16","2020-03-12","2020-08-25","2020-08-25","2021-09-28","2021-11-02","2021-11-02","2021-09-22","2020-04-28"],"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":[["","62175061746","PANTOPRAZOLE","SODDR40MGTAB","30","Select","Select",""],["","116200116","CHLORHEXIDINE","0.0012RINSE","473","Select","Select",""],["","68682011203","PIMECROLIMUS","0.01CREAM","100","Select","Select",""],["","65862019105","CYCLOBENZAPRINE","10MGTABLET","20","Select","Select",""],["","16714011302","FLUOXETINE","HCL20MGTABLET","30","Select","Select",""],["","65862006299","METOPROLOL","TARTRATE25MGTAB","1","Select","Select",""],["","16714078204","CLOBETASOL","0.0005OINTMENT","60","Select","Select",""],["","406012301","HYDROCODONE-ACETAMIN","5-325MG","20","Select","Select",""],["","67877022210","GABAPENTIN","100MGCAPSULE","21","Select","Select",""],["","55724021121","EUCRISA","0.02OINTMENT","60","Select","Select",""],["","16714008211","HYDROXYZINE","HCL25MGTABLET","20","Select","Select",""],["","63304069201","CLINDAMYCIN","HCL150MGCAPSULE","56","Select","Select",""],["","42192033901","HYOSCYAMINE","0.125MGTABSL","90","Select","Select",""],["","65862052790","VENLAFAXINE","HCLER37.5MGCAP","30","Select","Select",""],["","59267100001","PFIZER","COVID-19VACCINE(EUA)","0.3","Select","Select",""],["","16729020312","BUSPIRONE","HCL15MGTABLET","60","Select","Select",""],["","59746017310","PREDNISONE","10MGTABLET","30","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":""}]}]}