{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Patricia A Boatwright","gend":1,"add":"1403 Misty Valley Dr","city":"Chatsworth","state":"GA","zip":30705,"dob":"1981-10-31","age":"","mstatus":"","insh":4940433002,"cliId":"","pno":"","cno":"","email":"","ename":"","eno":"","pphy":"CHRISTINE DANFORTH","ppno":"","pcpadd":"1008 N 3rd Ave","pcpcity":"Chatsworth","pcpstate":"GA","pcpzip":"","pcpcounty":"Chatsworth","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":["E66.3","Z68.30","M54.16","G89.4","M54.5","M51.26","M47.816","M25.562","M25.561","Z79.891","R20.2","E06.3","R53.83","E78.5","I26.99","L65.9","K59.09","R63.5","R11.2","R10.32","R10.12","R42","E16.2","R00.2","M17.0","M79.10","M47.896","Z79.899","M25.50","S83.242","M54.50","Z76.89","Z71.3","F41.9","R07.9","Z13.6","N83.201","N83.202","E27.2","M47.817","M54.17","M25.512","I49.9","Z82.49","M48.061","M51.27","Z01.419","Z85.41","C53.9","Z90.710","M51.36","R07.2"],"date":["2021-12-21","2021-12-21","2021-12-28","2021-12-28","2021-09-28","2021-12-28","2021-12-28","2021-12-28","2021-12-28","2021-11-02","2021-10-19","2021-12-28","2021-12-28","2021-10-19","2021-10-19","2021-08-10","2021-08-10","2021-08-10","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-10-19","2021-12-07","2021-12-21","2021-12-21","2021-12-21","2021-08-10","2021-11-30","2021-12-28","2021-12-28","2021-10-19","2021-10-19","2021-11-02","2021-12-28","2021-12-28","2021-11-02","2021-11-02","2021-12-21","2021-11-18","2021-11-18","2021-11-18","2021-12-07","2021-11-23","2021-08-24","2021-08-24","2021-11-09","2021-11-09","2021-11-02","2021-11-02","2021-08-24","2021-12-07"],"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":[["","69547035302","NARCAN","4MGNASALSPRAY","2","Select","Select",""],["","69238183107","LEVOTHYROXINE","50MCGTABLET","30","Select","Select",""],["","57237007810","ONDANSETRON","ODT8MGTABLET","9","Select","Select",""],["","69097068205","PREGABALIN","150MGCAPSULE","30","Select","Select",""],["","68462015305","TOPIRAMATE","50MGTABLET","30","Select","Select",""],["","69097052444","DICLOFENAC","SODIUM0.01GEL","100","Select","Select",""],["","42806040021","METHYLPREDNISOLONE","4MGDOSEPK","21","Select","Select",""],["","29300012410","MELOXICAM","7.5MGTABLET","30","Select","Select",""],["","406051205","OXYCODONE-ACETAMINOPHEN","5-325","120","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":""}]}]}