{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James Gooch Jr","gend":0,"add":"92 Wren Drive","city":"Blairsville","state":"GA","zip":30512,"dob":"1991-12-15","age":"","mstatus":"","insh":4380405001,"cliId":"","pno":7064358436,"cno":"","email":"jakegooch2011@gmail.com","ename":"","eno":"","pphy":"William Breedlove","ppno":"","pcpadd":"162 Hospital Rd,Suite ","pcpcity":"Blairsville","pcpstate":"GA","pcpzip":"","pcpcounty":"Blairsville","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":["R74.8","N28.9","F17.210","L73.1","M1A.09X","Z79.899","Z68.28","L21.8","L73.2","M10.9","M25.572","K76.0","M79.662","B35.3","L84","M79.672","M10.072","F41.0"],"date":["2021-09-28","2021-06-01","2021-05-11","2021-02-09","2021-09-28","2021-09-28","2021-09-28","2021-05-18","2021-05-18","2021-12-07","2021-06-01","2021-05-11","2021-04-13","2021-09-28","2021-09-28","2021-09-28","2021-09-28","2021-09-28"],"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":[["","65862037401","ESCITALOPRAM","10MGTABLET","30","Select","Select",""],["","591544305","PREDNISONE","20MGTABLET","40","Select","Select",""],["","68462040601","INDOMETHACIN","25MGCAPSULE","21","Select","Select",""],["","67877058901","COLCHICINE","0.6MGTABLET","60","Select","Select",""],["","47335072283","FEBUXOSTAT","80MGTABLET","30","Select","Select",""],["","781107710","ALPRAZOLAM","0.5MGTABLET","60","Select","Select",""],["","299382345","SOOLANTRA","0.01CREAM","45","Select","Select",""],["","57237000511","FLUCONAZOLE","150MGTABLET","1","Select","Select",""],["","59267100001","PFIZER","COVID-19VACCINE(EUA)","0.3","Select","Select",""],["","27808003602","HYDROCODONE-ACETAMIN","7.5-325","20","Select","Select",""],["","93314705","CEPHALEXIN","500MGCAPSULE","20","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":""}]}]}