{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Patricia A Deaton","gend":1,"add":"39 Pullen Rd SE","city":"Lindale","state":"GA","zip":30147,"dob":"1958-07-20","age":"","mstatus":"","insh":4604594001,"cliId":"","pno":6789881448,"cno":"","email":"pdeaton58@gmail.com","ename":"","eno":"","pphy":"AMANDA REEVES","ppno":"","pcpadd":"500 Eagle Lake Trl,Suite 10","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":["G93.5","R11.0","H53.143","I10","Z87.891","E01.0","E78.2","R49.9","R53.83","J30.2","L21.9","Z12.31","R73.09","R79.89","R49.0","J41.0","K21.9","R51.9","Z00.01","L73.9","R21","R94.5","L82.1","L81.4","L85.3","E83.52","H69.83"],"date":["2021-11-02","2021-11-02","2021-11-02","2021-11-16","2021-11-02","2021-11-16","2021-11-23","2021-11-23","2021-09-02","2021-11-16","2021-04-27","2021-07-20","2021-08-10","2021-09-28","2021-11-23","2021-11-23","2021-11-23","2021-12-08","2021-08-10","2021-08-10","2021-08-10","2021-08-10","2021-04-27","2021-04-27","2021-04-27","2021-12-21","2021-11-16"],"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":[["","93505998","ATORVASTATIN","20MGTABLET","30","Select","Select",""],["","31722073190","IRBESARTAN","300MGTABLET","30","Select","Select",""],["","59267100001","PFIZER","COVID-19VACCINE(EUA)","0.3","Select","Select",""],["","51862054201","BUTALB-ACETAMIN-CAFF","50-300-40","14","Select","Select",""],["","59651000330","OMEPRAZOLE","DR40MGCAPSULE","30","Select","Select",""],["","45802006435","TRIAMCINOLONE","0.001CREAM","15","Select","Select",""],["","45802005935","NYSTATIN","100000UNIT\/GMCREAM","15","Select","Select",""],["","65162067684","AZELASTINE","0.001(137MCG)SPRY","30","Select","Select",""],["","16729022701","SPIRONOLACTONE","100MGTABLET","30","Select","Select",""],["","43598075205","BUPROPION","HCLSR150MGTABLET","30","Select","Select",""],["","93101042","MUPIROCIN","0.02OINTMENT","22","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":""}]}]}