{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Bradley W Rowland","gend":0,"add":"1698 N Summit Dr Unit 221","city":"Dalton","state":"GA","zip":30721,"dob":"1969-08-25","age":"","mstatus":"","insh":4143385001,"cliId":"","pno":7062801726,"cno":"","email":"bradley.rowland2017@yahoo.com","ename":"","eno":"","pphy":"KERRY NEISES","ppno":"","pcpadd":"1107 Memorial Dr,Suite 30","pcpcity":"Dalton","pcpstate":"GA","pcpzip":"","pcpcounty":"Dalton","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":["K86.3","R74.0","F10.10","Z71.41","F17.210","Z71.6","R03.0","D72.829","E80.6","K59.00","Z03.818","Z79.899","K85.20","R11.2","R10.10","E11.9","Z20.822","Z00.00","R11.10","K85.90","E29.1","R10.9","K86.89","D51.0","Z71.89","J01.90","Z20.828","B97.29","E11.65","K85.21","R74.01","R53.83","N52.9","L02.91"],"date":["2021-09-21","2021-01-12","2021-09-21","2021-01-12","2021-09-21","2021-01-12","2021-09-21","2021-09-21","2021-09-21","2021-01-12","2021-01-12","2021-01-12","2021-09-22","2021-10-12","2021-09-14","2021-09-14","2021-10-12","2020-09-08","2020-10-06","2021-10-12","2021-09-28","2021-09-14","2021-09-14","2021-04-13","2020-10-20","2020-10-20","2020-10-20","2020-10-20","2021-03-30","2021-09-21","2021-09-21","2021-02-02","2021-02-02","2020-12-22"],"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":[["","68001032103","BUPROPION","HCLXL300MGTABLET","30","Select","Select",""],["","68180016013","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","143965901","TESTOSTERONE","CYP200MG\/ML","1","Select","Select",""],["","193731150","CONTOUR","NEXTTESTSTRIP","50","Select","Select",""],["","50228010510","METFORMIN","HCL500MGTABLET","60","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TMP","DSTABLET","28","Select","Select",""],["","406012305","HYDROCODONE-ACETAMIN","5-325MG","12","Select","Select",""],["","67877019905","AMLODIPINE","BESYLATE10MGTAB","30","Select","Select",""],["","68462018022","MUPIROCIN","0.02OINTMENT","22","Select","Select",""],["","781261305","AMOXICILLIN","500MGCAPSULE","30","Select","Select",""],["","406048410","ACETAMINOPHEN-COD","#3TABLET","12","Select","Select",""],["","68001016100","PROMETHAZINE","12.5MGTABLET","60","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":""}]}]}