{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael J Rund","gend":0,"currentgend":"","add":"72 Alicia Ln Unit 488","city":"Dahlonega","state":"GA","zip":30533,"dob":"1957-10-17","age":"","mstatus":"","insh":"0000346948001","cliId":"","pno":6783410998,"cno":"","email":"mike33y3@gmail.com","ename":"","eno":"","pphy":"Mark Moers","ppno":7068643323,"pcpadd":"95 MORRISON MOORE PKWY W STE 100","pcpcity":"DAHLONEGA","pcpstate":"GA","pcpzip":30533,"pcpcounty":"","pcpid":"","pcpname":"95 MORRISON MOORE PKWY W STE 100","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"72 Alicia Ln Unit 488","madd2":"","madd3":"","mcity":"Dahlonega","mstate":"GA","mzip":30533,"pcpfaxno":7068644484,"pcpnpi":1962495234,"currentgendcomment":"","pphycomment":"","uniqueid":223286,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R53.82","D59.31","D69.6","Z23","M47.817","D64.9","K57.92","Z68.23","R19.5","Z79.899","D59.10","D59.2","K80.20","R16.1","Z15.01","F40.240","Z12.11","Z80.0","Z15.03","Z15.09","E78.2","K21.9","M10.9","H40.113","H35.372","H25.13","R73.01","M19.90","Z84.81","I10","E78.5","Z12.5","M51.17","M53.3","M79.18","M79.10","K76.89","R00.2","H04.123","H52.7","K40.90","Z00.00","G47.00","M62.838","M47.816","N40.1","N13.8","H40.112","H40.111","Z01.84","Z86.19","D59.9","Z68.22","F11.90","M43.17","K64.4","Z12.12","M46.1","R35.0","N34.2","Z71.2","M51.37","K29.60","T39.395","M47.27"],"date":["2026-02-18","2026-02-18","2025-07-28","2025-11-11","2026-02-18","2025-05-14","2025-04-23","2025-11-11","2026-02-18","2024-12-09","2025-08-18","2025-07-28","2026-02-18","2025-07-28","2025-07-28","2025-07-28","2025-08-05","2026-02-18","2025-07-28","2025-07-28","2026-02-18","2025-08-05","2024-02-06","2026-03-16","2024-09-12","2024-09-12","2026-03-11","2025-11-11","2025-07-07","2026-02-18","2025-07-07","2025-08-21","2025-07-17","2025-07-17","2025-07-17","2025-07-17","2025-07-15","2025-08-28","2025-08-18","2025-08-18","2024-10-16","2024-12-05","2026-02-18","2024-12-05","2024-12-05","2026-02-18","2024-12-05","2024-09-23","2024-09-23","2025-02-04","2025-08-11","2026-03-11","2026-03-11","2025-01-16","2026-02-18","2025-02-04","2024-06-27","2024-12-09","2025-08-04","2024-10-02","2025-07-29","2024-08-06","2025-08-04","2025-08-04","2025-07-15"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","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":[]}]},{"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":[]}]},{"t":"Allergies \/ Medications","q":[{"a":[]},{"a":{"comment":"","sub":[["","","Cimetidine","300 MG","","Select","Select",""],["","","Colchicine","0.6 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Terazosin","2 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","12 Hr Timolol","5 MG","","Select","Select",""],["","","Lumigan 0.01% Eye Drops","","","Select","Select",""],["","","Nebivolol","2.5 MG","","Select","Select",""],["","","Diflunisal","500 MG","","Select","Select",""],["","","Latanoprost","0.05 MG","","Select","Select",""],["","","Loteprednol Etabonate","5 MG","","Select","Select",""],["","","Simbrinza 1%-0.2% Eye Drop","","","Select","Select",""],["","","24 Hr Tramadol Hydrochloride","200 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Zaleplon","5 MG","","Select","Select",""],["","","Fluzone High-Dose Triv 2024-25","","","Select","Select",""],["","","Brimonidine-Timolol 0.2%-0.5%","","","Select","Select",""],["","","Metaxalone","800 MG","","Select","Select",""],["","","Hydrocortisone","25 MG","","Select","Select",""],["","","Diclofenac Potassium","50 MG","","Select","Select",""],["","","Ilevro","","","Select","Select",""],["","","Simbrinza","","","Select","Select",""],["","","Dorzolamide","20 MG","","Select","Select",""],["","","Misoprostol","0.1 MG","","Select","Select",""],["","","Bromfenac","0.9 MG","","Select","Select",""],["","","Temazepam","7.5 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","Guanfacine","1 MG","","Select","Select",""],["","","Tafluprost","0.015 MG","","Select","Select",""],["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Brimonidine Tartrate","2 MG","","Select","Select",""],["","","Lumigan","","","Select","Select",""],["","","Brimonidine Tartrate\/Timolol Maleate","","","Select","Select",""],["","","Sucralfate","1000 MG","","Select","Select",""],["","","Ursodiol","300 MG","","Select","Select",""],["","","Sulindac","150 MG","","Select","Select",""],["","","Erythromycin","0.005 MG","","Select","Select",""]]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Assessment of 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":[]}]},{"t":"Pain","q":[{"a":[]}]},{"t":"Vital Signs","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Exam Review","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Screenings Needed","q":[{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Mini-Cog","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Home Safety & Personal Goals","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"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":""}]}]}