{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kayla M Monday","gend":1,"add":"1222 Gunbarrel Rd","city":"Chattanooga","state":"TN","zip":37421,"dob":"1994-07-29","age":"","mstatus":"","insh":"AM1045292001","cliId":"","pno":4233135707,"cno":"","email":"kaylamonday94@yahoo.com","ename":"","eno":"","pphy":"Jeffeory White","ppno":"","pcpadd":"925 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":["Z23","E10.65","E55.9","R80.9","Z96.41","Z20.828","N93.9","L91.8","Z13.31","Z13.39","O03.9","F41.3","Z79.4","Z46.81","R63.4","J30.2","J45.20","L08.89","S61.258","W55.01X","F32.0","Z01.419"],"date":["2021-10-05","2021-10-26","2021-10-26","2021-10-26","2021-10-26","2020-06-23","2021-02-11","2021-06-08","2021-08-31","2021-08-31","2021-02-02","2021-09-07","2021-10-26","2021-10-26","2021-10-26","2021-03-30","2021-03-30","2021-09-28","2021-09-28","2021-09-28","2021-09-07","2020-11-24"],"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":[["","8627005303","DEXCOM","G6SENSOR","9","Select","Select",""],["","378623101","CITALOPRAM","HBR10MGTABLET","30","Select","Select",""],["","2751001","HUMALOG","100UNIT\/MLVIAL","50","Select","Select",""],["","93005401","BUSPIRONE","HCL10MGTABLET","45","Select","Select",""],["","2820705","LYUMJEV","100UNIT\/MLKWIKPEN","36","Select","Select",""],["","8290320550","BD","NANO2GENPENNDL32GX4MM","400","Select","Select",""],["","169750111","NOVOLOG","100UNIT\/MLVIAL","50","Select","Select",""],["","781185220","AMOX-CLAV","875-125MGTABLET","20","Select","Select",""],["","24587102","TOUJEO","MAXSOLOSTR300UNIT\/ML","9","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":["",""],"sub":{"indx":[["","","",""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":""}]}]}