{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Greg A Southerland","gend":0,"add":"3427 Headrick Cir SE","city":"Dalton","state":"GA","zip":30721,"dob":"1962-12-13","age":"","mstatus":"","insh":4197724001,"cliId":"","pno":7062718177,"cno":"","email":"nays1118@yahoo.com","ename":"","eno":"","pphy":"NATALIE BESSOM","ppno":"","pcpadd":"1012 Burleyson Rd","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":["G47.33","R07.89","R06.09","F17.210","R60.0","M47.814","M54.5","M54.2","M54.6","G89.4","M50.20","M51.26","M54.12","M54.16","M47.812","M47.816","Z79.891","I10","F32.9","Z12.5","M84.372","R07.2","R07.9","G25.2","F41.8","Z12.11","Z23","F17.200","R97.20","G25.81","J44.9","R06.02","Z87.891","Z68.35","G47.30","E78.00","M25.519","R06.00","M25.50","R97.8","Z20.822","Z20.2","M47.892","M51.36","M47.896","M51.34","M47.894","M13.812","M13.872"],"date":["2020-09-22","2020-03-12","2020-05-05","2021-12-28","2020-03-12","2021-05-11","2021-05-18","2021-05-18","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-12-28","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-12-28","2021-04-27","2021-04-27","2021-04-27","2020-05-12","2020-04-28","2021-11-16","2021-12-28","2021-12-28","2021-12-28","2021-11-16","2021-11-16","2020-03-31","2020-03-31","2020-03-31","2020-03-31","2020-03-31","2021-12-28","2021-12-28","2020-02-18","2020-02-18","2020-02-18","2020-02-18","2021-11-16","2021-11-16","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2021-05-11","2020-02-18","2021-02-16"],"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":[["","591040710","LISINOPRIL","10MGTABLET","30","Select","Select",""],["","68382009810","PAROXETINE","HCL20MGTABLET","30","Select","Select",""],["","69097067905","PREGABALIN","75MGCAPSULE","60","Select","Select",""],["","50111033402","METRONIDAZOLE","500MGTABLET","14","Select","Select",""],["","55111012305","ATORVASTATIN","40MGTABLET","30","Select","Select",""],["","93321205","CLONAZEPAM","1MGTABLET","15","Select","Select",""],["","68180071909","AMLODIPINE","BESYLATE2.5MGTAB","30","Select","Select",""],["","173068220","VENTOLIN","HFA90MCGINHALER","18","Select","Select",""],["","69547035302","NARCAN","4MGNASALSPRAY","2","Select","Select",""],["","68180051902","LISINOPRIL-HCTZ","20-12.5MGTAB","30","Select","Select",""],["","42858010450","OXYCODONE-ACETAMINOPHEN","10-325","28","Select","Select",""],["","65162010350","GABAPENTIN","400MGCAPSULE","60","Select","Select",""],["","60505384905","CELECOXIB","200MGCAPSULE","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":""}]}]}