{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Derek R Duncan","gend":0,"add":"784 Franklin Rd SW","city":"Plainville","state":"GA","zip":30733,"dob":"1992-06-08","age":"","mstatus":"","insh":4448490001,"cliId":"","pno":7069361735,"cno":"","email":"shae.duncan@yahoo.com","ename":"","eno":"","pphy":"JAY THOMAS","ppno":"","pcpadd":"304 Turner McCall Boulevard SW","pcpcity":"Rome","pcpstate":"GA","pcpzip":"","pcpcounty":"Rome","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":["J18.1","R19.7","Z20.822","E10.65","E10.40","D72.829","R09.02","F11.129","F19.129","F17.210","F41.9","Z79.4","R51.9","R94.31","I31.9","R11.2","S92.491","I10","F41.8","K21.9","G89.4","R07.9","E87.3","E83.52","Z72.0","J02.0","R09.89","F12.90","E11.9","K31.84","R68.83","F19.10","F10.10","F31.9","E11.43","R55","S92.901","K62.89","E10.9","E78.5","E11.40","G47.00","S92.404","M25.562","M25.561","E10.10","R07.1","A41.9","J69.0","R73.9","R10.32","R07.89","J18.9","R79.89","R06.02","I30.9","R10.9","I30.0","R74.8","G89.29","R56.9","E11.65","R07.2","I32","S80.211","G89.11","S92.421","J06.9","R00.0"],"date":["2021-09-07","2021-09-07","2021-12-14","2022-01-06","2021-11-09","2021-09-07","2021-09-07","2021-09-07","2021-09-07","2021-12-14","2021-12-07","2021-12-14","2021-10-26","2021-11-09","2021-11-30","2021-10-19","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2021-12-14","2021-12-08","2021-12-07","2021-12-07","2021-12-07","2021-12-07","2022-01-06","2021-06-08","2021-11-30","2021-09-07","2021-06-08","2021-06-08","2021-06-08","2021-08-24","2021-09-07","2022-01-06","2022-01-06","2021-04-20","2021-04-20","2021-07-13","2021-07-13","2021-07-13","2022-01-06","2021-12-14","2021-12-14","2021-11-23","2021-10-26","2021-09-07","2021-09-07","2021-09-07","2021-05-04","2021-11-02","2021-07-27","2021-08-31","2021-08-31","2021-09-07","2021-10-12","2021-10-26","2021-10-26","2021-11-09","2021-12-14","2021-11-23","2021-09-07","2021-09-07","2021-11-23","2021-11-23","2021-12-21","2021-10-12","2021-08-31"],"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":[["","65862052305","GABAPENTIN","600MGTABLET","120","Select","Select",""],["","68180044901","QUETIAPINE","FUMARATE300MGTAB","30","Select","Select",""],["","43598029490","PREGABALIN","100MGCAPSULE","90","Select","Select",""],["","406051201","OXYCODONE-ACETAMINOPHEN","5-325","28","Select","Select",""],["","13668000805","ZOLPIDEM","TARTRATE10MGTABLET","30","Select","Select",""],["","65862039010","ONDANSETRON","ODT4MGTABLET","24","Select","Select",""],["","406012305","HYDROCODONE-ACETAMIN","5-325MG","12","Select","Select",""],["","378668999","PANTOPRAZOLE","SODDR40MGTAB","14","Select","Select",""],["","143924920","AMOX-CLAV","875-125MGTABLET","9","Select","Select",""],["","68180016013","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","68180098003","LISINOPRIL","10MGTABLET","30","Select","Select",""],["","49884068905","METOCLOPRAMIDE","10MGTABLET","60","Select","Select",""],["","10702000350","PROMETHAZINE","25MGTABLET","12","Select","Select",""],["","68180071160","CEFDINIR","300MGCAPSULE","20","Select","Select",""],["","65162071009","COLCHICINE","0.6MGTABLET","60","Select","Select",""],["","16571020106","DICLOFENAC","SODEC75MGTAB","30","Select","Select",""],["","68645056354","IBUPROFEN","800MGTABLET","20","Select","Select",""],["","65862024608","LEVETIRACETAM","500MGTABLET","60","Select","Select",""],["","23155000810","HYDROCHLOROTHIAZIDE","25MGTAB","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}