{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lisa Hudson","gend":1,"add":"3050 Underwood Rd NE","city":"Dalton","state":"GA","zip":30721,"dob":"1963-11-13","age":"","mstatus":"","insh":"AS1003465002","cliId":"","pno":7062648428,"cno":"","email":"billyhudson61@gmail.com","ename":"","eno":"","pphy":"JAMES ZUPPA","ppno":"","pcpadd":"102 N Oaks Dr","pcpcity":"Dalton","pcpstate":"GA","pcpzip":"","pcpcounty":"Dalton","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":["M75.102","Z71.9","Z01.419","Z13.31","E03.9","Z79.899","E78.5","K90.9","R53.83","M13.0","R79.89","Z12.11","Z12.31","H69.93","H93.8X9","M19.071","N95.9","G89.18","Z23","N39.3","Z83.71","Z12.12","Z12.39","N95.1","L91.0","M21.611","Z79.890","K59.09","M25.512","Z09","Z86.010","K64.1","L71.9","F41.9","Z80.0","J01.91","L03.011","M75.02","R39.15","M13.871"],"date":["2020-03-24","2020-08-11","2021-08-10","2021-07-27","2021-08-31","2021-05-25","2021-03-23","2021-05-25","2021-05-25","2021-03-23","2021-03-23","2021-09-14","2021-08-10","2021-12-21","2021-12-21","2021-12-21","2021-11-16","2021-10-26","2021-12-14","2020-02-25","2021-08-03","2020-03-12","2020-03-12","2021-09-21","2020-02-18","2021-12-21","2021-08-31","2021-05-11","2020-09-29","2021-08-31","2021-08-31","2021-08-31","2020-02-25","2021-12-21","2021-09-14","2020-12-08","2021-04-27","2020-08-11","2020-03-03","2021-10-19"],"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":[["","69238183301","LEVOTHYROXINE","88MCGTABLET","30","Select","Select",""],["","378464226","ESTRADIOL","0.05MGPATCH","8","Select","Select",""],["","65862029390","ROSUVASTATIN","CALCIUM5MGTAB","30","Select","Select",""],["","68462010530","ONDANSETRON","HCL4MGTABLET","10","Select","Select",""],["","27808003502","HYDROCODONE-ACETAMIN","5-325MG","30","Select","Select",""],["","58160088752","FLUARIX","QUAD2021-2022SYRINGE","0.5","Select","Select",""],["","57237002801","AMOXICILLIN","500MGTABLET","30","Select","Select",""],["","65862042005","SULFAMETHOXAZOLE-TMP","DSTABLET","14","Select","Select",""],["","93224001","CEPHALEXIN","500MGTABLET","14","Select","Select",""],["","69238111501","BUSPIRONE","HCL5MGTABLET","60","Select","Select",""],["","33332032001","AFLURIA","QUAD2020-21(3YRUP)","0.5","Select","Select",""],["","57896092101","ASPIRIN","EC325MGTABLET","60","Select","Select",""],["","143980305","DOXYCYCLINE","HYCLATE100MGCAP","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":""}]}]}