{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dalton A Hall","gend":0,"add":"P.O. Box 7466 ","city":"Chestnut Mountain","state":"GA","zip":30502,"dob":"1991-10-06","age":"","mstatus":"","insh":"AM1037583001","cliId":"","pno":6783433066,"cno":"","email":"dhall061991@yahoo.com","ename":"","eno":"","pphy":"Christy Wagner","ppno":"","pcpadd":"1856 Thompson Bridge Road Ste 14","pcpcity":"Gainesville","pcpstate":"GA","pcpzip":"","pcpcounty":"Gainesville","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":["D48.5","L98.7","N13.2","K76.0","D21.21","I10","E66.01","R73.9","L81.4","D22.9","B35.3","U07.1","Z00.00","D22.5","N20.0","N20.1","Z68.42","R39.89","L97.519","L98.9","Z68.41","R05","R50.9","D18.01","L98.0","C44.519","R39.9"],"date":["2021-02-11","2020-12-08","2020-03-10","2021-10-12","2020-12-15","2021-10-12","2021-10-12","2021-10-12","2021-08-17","2021-02-11","2021-07-06","2020-07-14","2021-04-13","2020-08-18","2020-08-04","2020-08-04","2021-10-12","2020-05-05","2020-12-08","2020-12-08","2021-04-13","2020-07-07","2020-07-07","2021-08-17","2020-11-24","2021-03-23","2020-05-12"],"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":[["","43547041611","LISINOPRIL","10MGTABLET","90","Select","Select",""],["","68462029817","CLOTRIMAZOLE-BETAMETHASONE","CRM","15","Select","Select",""],["","93031401","KETOROLAC","10MGTABLET","20","Select","Select",""],["","51862017901","BUTALB-ACETAMIN-CAFF","50-325-40","16","Select","Select",""],["","67877021905","CEPHALEXIN","500MGCAPSULE","21","Select","Select",""],["","68382013201","TAMSULOSIN","HCL0.4MGCAPSULE","15","Select","Select",""],["","57237002901","AMOXICILLIN","875MGTABLET","20","Select","Select",""],["","69543013611","TRAMADOL","HCL50MGTABLET","20","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":""}]}]}