{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"JAMES ARNOLD","gend":0,"add":"61 Loblolly Ln","city":"Blairsville","state":"GA","zip":30512,"dob":"1960-06-17","age":"","mstatus":"","insh":4645601001,"cliId":"","pno":7068971627,"cno":"","email":"jwarnold2013@yahoo.com","ename":"","eno":"","pphy":"Alan Sanders","ppno":"","pcpadd":"194 Hospital Rd","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":["N17.9","R50.9","R05","R51.9","R79.82","R03.0","G47.33","N40.1","R33.9","N18.3","R23.8","I10","Z12.5","E78.5","M10.9","Z20.828","N28.9","R63.5","N13.8","R33.8","E66.01","Z68.41","G47.30","M19.90","Z79.899","Z88.5","D64.9","J01.00","J02.9","H69.82","H65.92","J20.9","D63.1","E55.9","E21.1","R97.20","R30.0","R35.0","Z90.79","N32.0","J01.90","R52","J01.80","H65.03","H92.03","J02.8","S37.20X","R39.0","J06.9","J01.01","R09.82","H92.02","H65.02","H69.93"],"date":["2021-11-09","2021-11-09","2021-11-09","2021-09-14","2021-09-14","2021-09-14","2022-01-06","2020-02-11","2020-01-14","2020-01-14","2021-07-20","2021-11-09","2021-09-14","2021-09-14","2021-09-14","2021-09-14","2021-03-16","2020-10-06","2020-02-04","2020-02-11","2020-02-04","2020-02-04","2021-06-29","2020-02-04","2020-02-04","2020-02-04","2021-03-16","2020-07-07","2021-06-22","2020-07-07","2020-07-07","2021-06-22","2020-04-09","2020-04-09","2020-04-09","2020-01-28","2020-02-11","2020-02-11","2020-02-11","2020-02-04","2021-06-22","2020-02-25","2021-06-29","2021-06-15","2021-06-15","2021-06-15","2020-02-11","2020-02-25","2021-08-24","2021-08-24","2020-05-05","2020-05-05","2020-05-05","2021-06-22"],"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":[["","31722013190","DUTASTERIDE","0.5MGCAPSULE","30","Select","Select",""],["","43547033750","BENAZEPRIL","HCL20MGTABLET","60","Select","Select",""],["","50111032801","HYDRALAZINE","50MGTABLET","60","Select","Select",""],["","50742062101","NIFEDIPINE","ER60MGTABLET","30","Select","Select",""],["","65862064163","AZITHROMYCIN","250MGTABLET","6","Select","Select",""],["","60505009600","DOXAZOSIN","MESYLATE8MGTAB","30","Select","Select",""],["","68001023703","CLONIDINE","HCL0.1MGTABLET","60","Select","Select",""],["","57237010199","METOPROLOL","TARTRATE50MGTAB","60","Select","Select",""],["","53746010901","HYDROCODONE-ACETAMIN","5-325MG","10","Select","Select",""],["","68180012202","CEPHALEXIN","500MGCAPSULE","40","Select","Select",""],["","59746017310","PREDNISONE","10MGTABLET","15","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","29300035005","ALLOPURINOL","300MGTABLET","30","Select","Select",""],["","76090101","HYOPHEN","TABLET","30","Select","Select",""],["","143924920","AMOX-CLAV","875-125MGTABLET","20","Select","Select",""],["","65862053650","LEVOFLOXACIN","250MGTABLET","1","Select","Select",""],["","228299650","TAMSULOSIN","HCL0.4MGCAPSULE","30","Select","Select",""],["","70461042010","FLUCELVAX","QUAD2020-2021VIAL","0.5","Select","Select",""],["","603497528","OXYBUTYNIN","5MGTABLET","15","Select","Select",""],["","16714043901","NITROFURANTOIN","MONO-MCR100MG","24","Select","Select",""],["","33332031901","AFLURIA","QUAD2019-20(3YRUP)","0.5","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":""}]}]}