{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tracy Brooks","gend":1,"currentgend":"","add":"743 Kerce Rd","city":"Kingston","state":"GA","zip":30145,"dob":"1970-06-24","age":"","mstatus":"","insh":"0001867674001","cliId":"","pno":7062526194,"cno":7062526194,"email":"tracygibson2301@gmail.con","ename":"","eno":"","pphy":"James Douglas","ppno":7062910884,"pcpadd":"15 RIVERBEND DR SW STE 200","pcpcity":"ROME","pcpstate":"GA","pcpzip":30161,"pcpcounty":"","pcpid":"","pcpname":"15 RIVERBEND DR SW STE 200","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"743 Kerce Rd","madd2":"","madd3":"","mcity":"Kingston","mstate":"GA","mzip":30145,"pcpfaxno":7062350405,"pcpnpi":1962489732,"currentgendcomment":"","pphycomment":"","uniqueid":253669,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N30.00","F29","F32.A","Z79.899","R07.2","M54.12","G43.101","S50.11X","M79.601","G43.009","G43.E01","M54.16","M47.816","F11.20","F45.42","G43.109","I25.10","E78.2","E53.8","G47.00","G43.909","M54.2","N39.0","G43.001","G43.111","T42.4X1","F51.01","F41.1","Z01.818","N30.01","Z86.79","J20.9","M67.432","N20.0","K57.30","Z87.440","G43.719","M53.82","R06.02","R10.9","I12.9","N18.9","G89.4","E78.5","I25.2","Z79.02","Z12.31","N30.90","R55","R00.0","I13.0","I50.9","Z87.898","Z90.5","I50.32","F41.9","R44.3","K21.9","K59.00","R11.0","M79.7","Z95.5","L29.9","Z88.5","Z13.39","Z78.9","R07.81","E66.3","Z87.442","Z79.1","M50.30","M47.812","G89.29","Z88.2","Z90.49","Z98.51","Z98.890","M62.838","L50.9","I11.0","K57.32","Z88.8","Z91.013","Z79.82","Z56.0","Z83.49","Z82.69","Z83.3","R94.31","I49.3","Z53.29","M51.36","I10","K57.92","E87.6","M62.830","R30.0","R51.9","R11.2","G56.22","R50.9","R07.9","H66.001","J06.9","J01.00","M47.22","F33.0","T42.4X4","R41.82","R03.0","R07.89","I21.9","I26.99","M48.02","Z09","M79.642","R10.10","R13.10","D53.9","Z86.19","M79.641","B08.1","Z00.00","Z68.25","H25.13","Z13.5","R05.1","L81.4","L57.0","R35.0","M06.4","G43.011","R79.89","G56.02","J20.8","L70.9","M67.40","K76.0","Z12.11","G43.709","R32","G43.819","K46.9","G56.01","G56.03","M25.50","M79.602","R20.2","Z79.891","M67.332","M65.322","I67.1","Z01.419","H53.143","M54.81","S09.93X","F13.10","Z63.0","Z83.719","M25.532","M79.89","S19.9XX","N95.1","R68.82","R10.13","R10.84","Z87.19","A41.9","D64.9","G24.3","R60.0","G56.23"],"date":["2026-01-15","2025-05-04","2025-05-04","2025-09-03","2024-12-19","2026-02-16","2024-08-08","2023-05-24","2024-01-17","2024-03-30","2025-03-18","2026-02-16","2026-02-16","2026-02-16","2026-02-16","2026-02-16","2026-01-31","2024-10-02","2026-01-15","2023-08-24","2025-05-26","2025-04-17","2023-09-25","2023-07-17","2026-01-15","2025-05-14","2026-01-15","2025-05-14","2025-05-14","2024-05-19","2026-01-15","2024-02-22","2024-11-06","2026-02-10","2026-02-03","2026-01-22","2024-04-16","2023-07-17","2024-12-19","2025-07-23","2024-05-19","2026-01-31","2026-01-31","2025-07-23","2026-01-31","2024-05-19","2025-05-21","2025-03-18","2025-03-18","2025-08-21","2026-01-31","2025-07-23","2025-03-18","2026-02-01","2026-01-31","2026-01-31","2026-01-31","2026-02-06","2026-02-03","2026-01-31","2026-01-31","2026-01-31","2026-02-06","2026-01-31","2025-03-17","2025-03-17","2023-01-28","2023-02-20","2025-08-21","2025-05-25","2024-11-11","2025-05-28","2025-05-26","2025-07-23","2024-10-02","2024-10-02","2024-10-02","2026-01-15","2026-01-15","2025-07-23","2025-08-23","2025-07-23","2025-05-25","2025-08-21","2025-05-25","2025-05-25","2025-05-25","2025-05-25","2025-07-23","2025-07-23","2025-07-23","2023-10-30","2025-09-03","2025-08-25","2025-08-25","2024-02-12","2026-01-15","2024-03-16","2026-02-06","2025-07-08","2024-10-02","2025-07-23","2023-11-02","2023-11-02","2023-11-02","2025-04-22","2023-12-07","2025-05-03","2025-08-23","2025-05-03","2024-12-19","2023-01-28","2023-01-28","2025-05-28","2026-02-10","2025-05-14","2024-08-08","2024-08-08","2025-08-21","2025-08-21","2025-05-14","2023-12-07","2024-06-11","2024-06-11","2025-06-24","2025-06-24","2024-02-16","2025-05-29","2025-05-29","2023-09-25","2025-05-14","2023-02-21","2024-05-18","2024-11-06","2024-02-16","2023-06-08","2023-06-08","2026-02-03","2024-05-08","2024-05-06","2023-06-07","2024-12-12","2024-12-12","2024-02-01","2025-06-10","2023-03-20","2024-01-17","2024-01-17","2023-06-12","2025-05-14","2025-05-14","2024-08-21","2025-05-21","2024-03-16","2024-03-14","2025-03-18","2025-05-04","2025-05-04","2024-05-08","2023-07-11","2024-01-04","2025-03-18","2023-02-03","2023-02-03","2025-09-23","2025-09-23","2025-09-23","2025-05-26","2025-09-03","2024-04-16","2026-02-05","2025-06-10"],"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":[["","","Oxycodone Hydrochloride","15 MG","","Select","Select",""],["","","Eszopiclone","3 MG","","Select","Select",""],["","","Vitamin B12","1 MG","","Select","Select",""],["","","Lidocaine","0.05 MG","","Select","Select",""],["","","Promethazine Hydrochloride","50 MG","","Select","Select",""],["","","Promethazine","50 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","1 Ml Testosterone Cypionate","200 MG","","Select","Select",""],["","","Lorazepam","2 MG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Metoprolol Tartrate","25 MG","","Select","Select",""],["","","Butalb-Acetamin-Caff 50-325-40","","","Select","Select",""],["","","1.5 Ml Fremanezumab-Vfrm","150 MG","","Select","Select",""],["","","Belsomra","20 MG","","Select","Select",""],["","","Ciprofloxacin Hcl","500 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Oxycodone Hcl Ir","15 MG","","Select","Select",""],["","","Polyethylene Glycol 3350","240000 MG","","Select","Select",""],["","","Duloxetine","30 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Nitrofurantoin Mcr","50 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Triazolam","0.25 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Nitrofurantoin, Macrocrystals","25 MG","","Select","Select",""],["","","Clonidine Hydrochloride","0.1 MG","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Olanzapine","20 MG","","Select","Select",""],["","","Tizanidine","4 MG","","Select","Select",""],["","","Trazodone Hydrochloride","100 MG","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","0.5 Ml Sumatriptan","12 MG","","Select","Select",""],["","","Lemborexant","10 MG","","Select","Select",""],["","","Promethegan","25 MG","","Select","Select",""],["","","Clopidogrel","75 MG","","Select","Select",""],["","","Naproxen","500 MG","","Select","Select",""],["","","Tretinoin","0.5 MG","","Select","Select",""],["","","Phenazopyridine Hydrochloride","200 MG","","Select","Select",""],["","","Temazepam","30 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Fluticasone Propionate","0.05 MG","","Select","Select",""],["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Verapamil Hydrochloride","40 MG","","Select","Select",""],["","","Hydroxyzine Hydrochloride","","","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":""}]}]}