{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lou A Dresher","gend":1,"add":"1130 Cumberland Valley Rd","city":"Gainesville","state":"GA","zip":30501,"dob":"1957-04-03","age":"","mstatus":"","insh":4173413001,"cliId":"","pno":7703633203,"cno":"","email":"adresher5775@gmail.com","ename":"","eno":"","pphy":"Ellen Sanders","ppno":"","pcpadd":"4222 Fairbanks Dr","pcpcity":"Oakwood","pcpstate":"GA","pcpzip":"","pcpcounty":"Oakwood","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":["M47.26","M99.33","M46.1","Z79.891","H61.031","L82.1","Z71.89","L57.0","L82.0","Z01.419","Z12.11","Z12.31","F32.9","N95.1","R19.5","Z68.22","M53.3","M25.552","F41.1","M25.9","R22.9","Z68.25","M19.041","R00.2","Z20.828","M79.643","I73.00","R53.83","Z82.49","R20.0","R20.2","Z68.23","M54.16","R87.610","M54.59","G89.29","Z79.899","Z01.411","R07.9","Z91.89","Z13.220","Z68.21","M48.061","M51.17","F19.20"],"date":["2020-10-20","2020-10-20","2020-10-20","2020-03-10","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-03-16","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-05-25","2021-11-18","2021-11-18","2020-01-28","2020-03-03","2020-10-06","2020-10-06","2021-02-09","2020-12-29","2022-01-06","2020-08-04","2021-12-28","2020-12-29","2021-12-28","2020-12-29","2020-12-29","2020-12-29","2020-03-03","2020-04-28","2021-11-09","2020-07-21","2020-10-20","2020-05-05","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2020-03-03","2020-03-03","2020-04-09"],"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":[["","59651015301","PROGESTERONE","200MGCAPSULE","30","Select","Select",""],["","17139061740","ESTROGEL","0.0006GEL","50","Select","Select",""],["","51991074890","DULOXETINE","HCLDR60MGCAP","30","Select","Select",""],["","68180018001","CEFADROXIL","500MGCAPSULE","14","Select","Select",""],["","527133850","DOXYCYCLINE","MONO100MGTABLET","14","Select","Select",""],["","23155005901","VERAPAMIL","40MGTABLET","90","Select","Select",""],["","65862039110","ONDANSETRON","ODT8MGTABLET","20","Select","Select",""],["","378647099","SCOPOLAMINE","1MG\/3DAYPATCH","1","Select","Select",""],["","42858010401","OXYCODONE-ACETAMINOPHEN","10-325","20","Select","Select",""],["","59746000103","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","65162052110","PROMETHAZINE","25MGTABLET","20","Select","Select",""],["","574220520","TRETINOIN","0.0005CREAM","40","Select","Select",""],["","49281042050","FLUZONE","QUAD2020-2021SYRINGE","0.5","Select","Select",""],["","59267100002","PFIZER","COVID-19VACCINE(EUA)","0.3","Select","Select",""],["","172392770","DIAZEPAM","10MGTABLET","1","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":""}]}]}