{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Susan Elizabeth Ogle","gend":1,"currentgend":"","add":"818 N 6th Ave","city":"Chatsworth","state":"GA","zip":"30705","dob":"1966-04-02","age":60,"mstatus":"","insh":"0000434700001","cliId":"","pno":"7062180099","cno":"7062180099","email":"Susanogle84@gmail.com","ename":"","eno":"","pphy":"Yara Fattouh","ppno":"7066955500","pcpadd":"1111 HIGHWAY 76","pcpcity":"CHATSWORTH","pcpstate":"GA","pcpzip":"30705","pcpcounty":"","pcpid":"","pcpname":"1111 HIGHWAY 76","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"818 N 6th Ave","madd2":"","madd3":"","mcity":"Chatsworth","mstate":"GA","mzip":"30705","pcpfaxno":"7066955512","pcpnpi":"1518953785","currentgendcomment":"","pphycomment":"","uniqueid":"226351","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K21.00","K76.0","K22.70","Z98.890","E53.8","S42.302","N39.0","K21.9","F90.2","E03.9","D64.9","R00.2","F41.1","L90.0","R05.1","J06.9","I10","R53.83","F90.9","F41.0","S52.532","E03.8","Z79.83","M87.9","L57.0","L57.8","D23.9","D18.01","L85.9","L81.4","L81.6","E06.3","K59.09","Z98.84","Z12.31","S92.352","D13.2","K44.9","Q39.9","F32.A","Z88.0","Z88.2","Z88.1","Z91.040","Z79.890","Z79.899","Z87.891","R06.2","N39.41","Z72.89","Z68.28","M81.0","K74.00","F33.1","S52.502","W18.2XX","K59.04","S52.612","E07.9","F17.290","Z88.8","G89.18","F43.23","Z13.31","D50.8","S52.592","S52.615","N39.46","N81.10"],"date":["2026-04-15","2026-08-04","2026-08-04","2026-04-05","2026-07-20","2026-04-29","2026-04-29","2026-07-20","2026-04-29","2026-04-29","2026-07-20","2026-08-12","2026-08-12","2026-08-10","2026-02-18","2026-02-18","2026-08-12","2026-07-22","2026-07-22","2026-07-22","2026-05-26","2026-08-12","2026-02-02","2026-02-02","2026-06-17","2026-06-17","2026-06-17","2026-06-17","2026-06-17","2026-06-17","2026-06-17","2026-08-04","2026-05-19","2026-07-20","2026-08-05","2026-07-23","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-02-03","2026-02-03","2026-02-03","2026-03-04","2026-02-02","2026-08-04","2026-03-04","2026-04-05","2026-04-05","2026-06-10","2026-04-05","2026-04-05","2026-04-05","2026-04-05","2026-04-08","2026-01-19","2026-01-19","2026-08-04","2026-04-05","2026-04-05","2026-08-10","2026-08-10"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"score":[0,0,0,0]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"arr":[],"comment":[]},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"index":-1,"comment":"","sub":[]},{"a":[{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],{"comment":""}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","LAMOTRIGINE","25000 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","100000 MCG","","Select","Select",""],["","","BUSPIRONE HCL","15000 MG","","Select","Select",""],["","","CLONAZEPAM","500 MG","","Select","Select",""],["","","AMPHETAMINE\/DEXTROAMPHETAMINE","0","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50000 MG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4000 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","0","","Select","Select",""],["","","CLOTRIMAZOLE\/BETAMETHASONE DIPROPIONATE","0","","Select","Select",""],["","","OMEPRAZOLE","40000 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS","100000 MG","","Select","Select",""],["","","TACROLIMUS","100 %","","Select","Select",""],["","","MONTELUKAST SODIUM","10000 MG","","Select","Select",""],["","","TRULANCE","3000 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE","60 %","","Select","Select",""],["","","BETAMETHASONE VALERATE","100 %","","Select","Select",""],["","","AMLODIPINE BESYLATE","5000 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","0","","Select","Select",""],["","","CLOBETASOL PROPIONATE","50 %","","Select","Select",""],["","","BUPROPION HYDROCHLORIDE ER (XL)","300000 MG","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}}]},{"t":"Assessment of Diagnoses","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false],"comment":["","","","","","","",""],"score":["","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Pain","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]]}}]},{"t":"Vital Signs","q":[{"a":["","","","","","","",false,false,false]},{"a":["","","","",{"txt":""},{"malnutrition":{"indx":["","","","","","",""],"sub":{"indx":[],"comment":[],"sub":[]}}}]},{"arr":[],"comment":[]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"arr":[],"comment":[]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","",""],"comment":["","","","","","","","",""],"sub":[]}},{"a":{"indx":[],"comment":[],"score":[]}}]},{"t":"Exam Review","q":[{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":[""],"comment":[""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"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":{"indx":[false,false,false],"comment":["","",""],"score":["","",""]}}]},{"t":"Mini-Cog","q":[{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":{"data":["","1","","","","0"],"indx":[false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false],"version":[false,false,false,false,false,false]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Home Safety & Personal Goals","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","","","",""],"comment":["","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"select","a10":[],"a11":"","a12":"","a13":"","a15":[],"a14":"","a16":"","a18":"","a20":"","a21":""}]}]}