{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karen Whitaker","gend":1,"currentgend":"","add":"3805 Cherokee Frd","city":"Gainesville","state":"GA","zip":30506,"dob":"1964-11-30","age":"","mstatus":"","insh":"0001505416003","cliId":"","pno":7705404400,"cno":7705404400,"email":"thetwistedwhiskbakery@gmail.com","ename":"","eno":"","pphy":"Ugochukwu Egolum","ppno":7705342020,"pcpadd":"743 SPRING ST NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013715,"pcpcounty":"","pcpid":"","pcpname":"743 SPRING ST NE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"3805 Cherokee Frd","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30506,"pcpfaxno":"","pcpnpi":1558687384,"currentgendcomment":"","pphycomment":"","uniqueid":236761,"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":["M47.817","Q79.60","G89.29","Z79.899","R05.3","E66.9","J45.909","Z68.35","D50.9","D52.9","G31.84","R42","R53.81","R53.83","R79.1","E27.40","B96.89","B37.9","E34.9","E03.9","L65.9","M25.50","E83.9","E63.9","D84.9","N95.1","M54.16","R74.8","D64.9","M79.604","M79.605","R29.898","M62.81","R07.9","F41.9","T40.995","E11.9","I10","Z87.891","M54.41","R91.1","M48.061","M51.26","M51.37","E06.3","E89.0","E53.8","E55.9","M54.50","M25.551","M47.816","M25.552","Z68.36","Z00.00","I50.42","I11.0","E72.12","M54.6","E87.5","R82.998","I50.9","F41.8","J01.40","I42.0","I44.7","E66.812","E66.01","Z01.818","E11.65","A69.20","G43.709","R06.83","G47.19","U07.1","S39.012","M54.89","Z68.34","M16.0","M51.17","M54.42","T50.905","M47.814","J34.89","J34.2","J45.20","Z78.0","Z91.89"],"date":["2025-04-14","2025-04-14","2025-04-14","2025-04-14","2023-12-27","2024-08-02","2024-10-07","2025-05-14","2023-12-15","2025-10-31","2025-10-31","2025-10-31","2023-08-25","2023-08-25","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2024-10-11","2024-10-11","2025-10-31","2025-02-14","2025-07-24","2024-05-07","2023-08-25","2025-03-31","2025-03-31","2024-03-28","2024-03-28","2024-07-03","2024-07-03","2024-07-03","2024-08-02","2024-07-31","2024-08-02","2024-08-02","2024-07-31","2025-04-14","2024-08-02","2024-08-02","2023-04-04","2023-04-04","2023-04-04","2023-04-04","2025-04-14","2025-03-07","2025-03-07","2025-03-07","2025-05-14","2024-08-20","2025-11-06","2024-08-20","2024-08-20","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-09-10","2024-02-09","2025-05-14","2025-05-14","2025-05-14","2025-05-14","2025-04-09","2025-04-09","2025-04-09","2026-02-09","2026-02-09","2026-02-09","2024-08-08","2024-07-31","2024-07-31","2023-06-02","2025-01-16","2024-08-15","2024-08-02","2024-07-03","2024-08-02","2024-03-26","2024-03-26","2025-04-28","2025-03-27","2025-02-20"],"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",""],["","","Hydrocortisone","10 MG","","Select","Select",""],["","","Carvedilol","25 MG","","Select","Select",""],["","","Spironolactone","25 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","84 Hr Estradiol","0.00208 MG","","Select","Select",""],["","","Cyanocobalamin 1,000 Mcg\/Ml Vl","","","Select","Select",""],["","","Thyroid Usp","90 MG","","Select","Select",""],["","","Advair Hfa 115-21 Mcg Inhaler","","","Select","Select",""],["","","24 Hr Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Farxiga","10 MG","","Select","Select",""],["","","Fluconazole","200 MG","","Select","Select",""],["","","Furosemide","20 MG","","Select","Select",""],["","","Sure Comfort","1 ML","","Select","Select",""],["","","Entresto","24 MG","","Select","Select",""],["","","Pregabalin","50 MG","","Select","Select",""],["","","Ubrelvy","100 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Nabumetone","500 MG","","Select","Select",""],["","","Paxlovid 300-100 Mg Pack (Eua)","","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Benzonatate","100 MG","","Select","Select",""],["","","Lidocaine 5% Patch","","","Select","Select",""],["","","Meloxicam","15 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Ibuprofen","600 MG","","Select","Select",""],["","","Nda021457 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Estradiol","0.01 MG","","Select","Select",""],["","","Cyanocobalamin","","","Select","Select",""],["","","Advair Hfa","","","Select","Select",""],["","","Mupirocin","","","Select","Select",""],["","","Hydroxyzine Pamoate","","","Select","Select",""],["","","Sacubitril\/Valsartan","","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 Mg","","","Select","Select",""],["","","Paxlovid 300-100 Mg Dose Pack","","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Sure Comfort Insulin Syringe\/U-100\/1Ml\/30G X 1\/2\"","","","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":""}]}]}