{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeremy Scot Sisum","gend":0,"currentgend":"","add":"8029 Blue Ridge Hwy","city":"Blairsville","state":"GA","zip":30512,"dob":"1976-07-13","age":49,"mstatus":"","insh":"0001834946003","cliId":"","pno":7068357580,"cno":7067819349,"email":"jssisum@gmail.com","ename":"","eno":"","pphy":"Christopher Hass","ppno":7064396858,"pcpadd":"35 HOSPITAL RD","pcpcity":"BLAIRSVILLE","pcpstate":"GA","pcpzip":305123139,"pcpcounty":"","pcpid":"","pcpname":"35 HOSPITAL RD","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"8029 Blue Ridge Hwy","madd2":"","madd3":"","mcity":"Blairsville","mstate":"GA","mzip":30512,"pcpfaxno":"","pcpnpi":1790133577,"currentgendcomment":"","pphycomment":"","uniqueid":238445,"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":["I65.23","I73.9","M45.6","Z47.89","R07.9","W19.XXX","Z04.3","S42.001","S99.912","S99.911","R51.9","K21.9","E83.119","D50.9","I10","S00.81X","S20.211","S50.312","S93.402","S93.401","Z87.891","R94.39","F17.290","I11.9","I25.10","Z79.899","R07.2","E78.2","R79.9","R53.83","N40.0","E55.9","E72.11","R97.8","R97.20","S20.213","S01.01X","R07.89","J12.82","E87.1","F10.131","R44.1","J32.9","Z90.49","M25.511","Z90.89","M45.5","M54.59","G89.29","J10.1","R50.9","Z01.818","K86.1","G47.00","F32.9","F11.10","F10.10","J40","R25.1","T88.1XX","K86.89","E29.1","E11.8","E11.9","M47.817","K21.00","K29.50","M47.26","Z01.810","E78.5","Z68.27","M51.34","Z68.26","Z79.01","M54.6","S42.021","G89.18","M99.03","M99.02","M99.05","Z97.8","M89.8X1","U07.1","F10.939","H92.03","H92.13","K86.3","J98.4","J98.11","M47.814","M47.816","M46.1","I86.8","K56.1","M51.06","R41.3","M25.551","K44.9","Z90.3","F41.9","K76.0","Z87.19","Z79.1","H53.2","M51.17","Z98.890","M48.062","I67.82","S29.9XX","S39.91X","R10.13","M16.11","M25.562","W11.XXX","E87.5","K29.60","K20.80","G83.10","Z09","S49.91X","F10.239","R00.0","I25.118","Z68.28","H90.3","R79.89","E66.3","M51.26","M48.061","M85.89","M47.896"],"date":["2026-03-12","2026-03-12","2025-01-13","2024-02-14","2025-08-26","2024-12-11","2023-11-11","2025-02-26","2023-11-11","2023-11-11","2025-08-25","2025-03-27","2024-12-11","2025-03-27","2025-03-27","2023-11-11","2023-11-11","2023-11-11","2023-11-11","2023-11-11","2023-11-11","2025-09-02","2025-09-02","2026-03-12","2026-01-26","2025-09-02","2026-01-21","2025-08-27","2025-05-29","2025-02-10","2025-02-10","2025-02-10","2025-02-10","2025-02-10","2025-02-10","2023-11-11","2023-11-11","2025-08-25","2024-12-14","2025-09-03","2024-12-11","2024-12-11","2024-12-11","2024-12-11","2024-02-14","2024-06-27","2024-01-22","2023-06-20","2024-01-22","2023-02-07","2023-02-07","2026-03-11","2025-02-25","2023-02-17","2023-02-17","2023-02-17","2023-02-17","2023-02-17","2023-02-17","2023-02-17","2025-02-25","2024-02-14","2025-05-29","2026-01-29","2023-08-03","2025-03-27","2025-03-27","2024-06-27","2026-03-12","2026-03-12","2026-01-26","2025-08-08","2025-09-05","2024-01-22","2023-10-16","2023-11-14","2023-11-14","2026-01-13","2026-01-13","2026-01-13","2025-02-26","2025-02-26","2024-12-14","2024-12-14","2025-01-30","2025-01-09","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-02-25","2025-07-28","2024-12-04","2024-12-04","2025-03-27","2025-03-27","2025-03-27","2025-03-27","2025-03-27","2025-03-27","2023-03-03","2024-01-22","2024-01-22","2025-09-05","2024-12-11","2024-12-11","2024-12-11","2025-03-27","2024-12-04","2023-11-13","2023-11-13","2025-09-03","2025-03-27","2025-03-27","2025-08-08","2023-09-14","2024-12-11","2024-12-11","2024-12-11","2026-03-12","2026-03-12","2025-01-30","2023-11-13","2023-10-05","2024-08-30","2024-08-30","2025-02-03","2025-08-08"],"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":[["","","24 Hr Metoprolol Succinate","50 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Azithromycin","500 MG","","Select","Select",""],["","","Janumet","","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Pregabalin","300 MG","","Select","Select",""],["","","Dexlansoprazole","60 MG","","Select","Select",""],["","","Vonoprazan","20 MG","","Select","Select",""],["","","1 Ml Etanercept","50 MG","","Select","Select",""],["","","Tadalafil","5 MG","","Select","Select",""],["","","Diazepam","","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Rosuvastatin Calcium","20 MG","","Select","Select",""],["","","Nitroglycerin","0.4 MG","","Select","Select",""],["","","24 Hr Isosorbide Mononitrate","30 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Gabapentin","800 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Cephalexin","","","Select","Select",""],["","","Fentanyl","100 MCG","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Buprenorphine-Nalox 8-2 Mg Tab","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Tizanidine","4 MG","","Select","Select",""],["","","Ketorolac Tromethamine","10 MG","","Select","Select",""],["","","Alendronic Acid","70 MG","","Select","Select",""],["","","Mupirocin","0.02 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":[]}}}]},{"a":{"indx":["","","","","","","","","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"arr":[],"comment":[]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","",""],"comment":["","","","","","","","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"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":""}]}]}