{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Paula Hanna Bice","gend":1,"currentgend":"","add":"921 Mustang Dr","city":"Summerville","state":"GA","zip":30747,"dob":"1989-10-11","age":"","mstatus":"","insh":"0001292948001","cliId":"","pno":7066220415,"cno":7066220415,"email":"paulabice11@gmail.com","ename":"","eno":"","pphy":"Megan Brown","ppno":7069654060,"pcpadd":"45 COLLEGE PARK DR STE A","pcpcity":"RINGGOLD","pcpstate":"GA","pcpzip":30736,"pcpcounty":"","pcpid":"","pcpname":"45 COLLEGE PARK DR STE A","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"921 Mustang Dr","madd2":"","madd3":"","mcity":"Summerville","mstate":"GA","mzip":30747,"pcpfaxno":7069654080,"pcpnpi":1790065233,"currentgendcomment":"","pphycomment":"","uniqueid":227677,"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":["F64.9","F41.1","Z79.899","F32.A","G47.00","F43.10","F40.10","F33.1","I42.1","E46","Z01.818","R60.1","F33.9","K01.1","Z79.890","E78.5","I42.2","I25.10","I10","D75.839","Z80.9","F64.0","Z88.0","F41.9","Z59.869","D72.829","Z01.810","T81.40X","R22.0","N89.5","I51.7","Z78.9","L03.90","L02.91","Z90.79","R73.09","I95.1","R07.0","R68.89","U07.1","Z11.2","Z03.818","E53.8","E66.9","T81.31X","Z68.27","T84.69X","R53.83","Z13.220","Z51.81","L92.8","N93.9","Z94.5","N93.8","E78.1","R06.02","R01.1","Z68.28","M27.2","J98.11","L90.5","J00"],"date":["2026-02-09","2025-12-11","2025-02-28","2025-12-16","2025-02-28","2025-12-11","2025-12-11","2025-12-11","2025-08-12","2025-07-15","2025-07-16","2025-07-15","2024-08-30","2025-10-20","2025-10-20","2026-02-09","2026-02-09","2026-02-09","2025-03-15","2024-07-29","2024-07-29","2025-12-16","2025-12-16","2025-12-16","2025-12-16","2024-08-27","2025-07-18","2025-12-17","2025-12-16","2025-11-03","2024-04-22","2024-08-27","2025-11-22","2025-11-22","2023-11-21","2025-07-15","2025-07-18","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-08-27","2025-03-15","2025-03-23","2025-03-15","2025-12-17","2024-01-22","2024-01-22","2025-06-16","2025-11-03","2025-11-03","2025-03-23","2026-02-09","2025-06-11","2023-01-27","2023-01-27","2023-01-27","2025-11-22","2025-03-23","2025-03-15","2023-11-13"],"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":[["","","Progesterone","200 MG","","Select","Select",""],["","","Finasteride","5 MG","","Select","Select",""],["","","Metoprolol Tartrate","50 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Estradiol Valerate","200 MG","","Select","Select",""],["","","Lidocaine-Prilocaine Cream","","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Levocetirizine Dihydrochloride","5 MG","","Select","Select",""],["","","Cyanocobalamin 1,000 Mcg\/Ml Vl","","","Select","Select",""],["","","Sertraline","25 MG","","Select","Select",""],["","","Trazodone Hydrochloride","100 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","300 MG","","Select","Select",""],["","","Buspirone Hcl","15 MG","","Select","Select",""],["","","Clonazepam","0.5 MG","","Select","Select",""],["","","Quetiapine","200 MG","","Select","Select",""],["","","Buspirone Hydrochloride","10 MG","","Select","Select",""],["","","Doxepin","50 MG","","Select","Select",""],["","","Prazosin Hydrochloride","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Prazosin","2 MG","","Select","Select",""],["","","Clindamycin","300 MG","","Select","Select",""],["","","Chlorhexidine Gluconate","","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Erythromycin","0.005 MG","","Select","Select",""],["","","Pregabalin","75 MG","","Select","Select",""],["","","Doxazosin","1 MG","","Select","Select",""],["","","Risperidone","0.5 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Mirtazapine","30 MG","","Select","Select",""],["","","Ibuprofen","600 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Methylprednisolone","4 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":""}]}]}