{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rebecca Hair","gend":1,"add":"1242 Hendrick Rd","city":"Fort Valley","state":"GA","zip":31030,"dob":"1973-04-13","age":"","mstatus":"","insh":4604484001,"cliId":"","pno":4789515440,"cno":"","email":"1beckie.hair73@gmail.com","ename":"","eno":"","pphy":"Heather Givens","ppno":"","pcpadd":"556 Third St,Suite ","pcpcity":"Macon","pcpstate":"GA","pcpzip":"","pcpcounty":"Macon","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":["I87.2","M79.604","M79.605","I83.812","I83.811","R68.89","L30.9","L20.9","R21"],"date":["2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-06","2021-07-27","2021-09-07","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":[["","406012501","HYDROCODONE-ACETAMIN","10-325MG","25","Select","Select",""],["","68462010230","FLUCONAZOLE","100MGTABLET","1","Select","Select",""],["","21922001707","CLOBETASOL","0.0005OINTMENT","60","Select","Select",""],["","68180051802","LISINOPRIL-HCTZ","10-12.5MGTAB","30","Select","Select",""],["","406051201","OXYCODONE-ACETAMINOPHEN","5-325","10","Select","Select",""],["","50111056101","TRAZODONE","100MGTABLET","30","Select","Select",""],["","185012201","NITROFURANTOIN","MONO-MCR100MG","14","Select","Select",""],["","59746000106","METHYLPREDNISOLONE","4MGTABLET","21","Select","Select",""],["","33342002332","LEVOFLOXACIN","750MGTABLET","5","Select","Select",""],["","55111017915","TIZANIDINE","HCL2MGTABLET","42","Select","Select",""],["","143980305","DOXYCYCLINE","HYCLATE100MGCAP","7","Select","Select",""],["","68180098003","LISINOPRIL","10MGTABLET","30","Select","Select",""],["","68382013210","TAMSULOSIN","HCL0.4MGCAPSULE","7","Select","Select",""],["","68462015713","ONDANSETRON","ODT4MGTABLET","24","Select","Select",""],["","143992801","CIPROFLOXACIN","HCL500MGTAB","6","Select","Select",""],["","55111029398","SUMATRIPTAN","SUCC100MGTABLET","9","Select","Select",""],["","527058610","DICYCLOMINE","10MGCAPSULE","28","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":""}]}]}