{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carey Luna","gend":0,"currentgend":"","add":"6700 Duncan Bridge Rd","city":"Cleveland","state":"GA","zip":30528,"dob":"1961-11-25","age":"","mstatus":"","insh":"0001921165001","cliId":"","pno":7068090057,"cno":7063483034,"email":"ccluna25@yahoo.com","ename":"","eno":"","pphy":"Timothy Carey","ppno":7702975700,"pcpadd":"725 JESSE JEWELL PKWY SE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013834,"pcpcounty":"","pcpid":"","pcpname":"725 JESSE JEWELL PKWY SE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"6700 Duncan Bridge Rd","madd2":"","madd3":"","mcity":"Cleveland","mstate":"GA","mzip":30528,"pcpfaxno":7707181187,"pcpnpi":1174725345,"currentgendcomment":"","pphycomment":"","uniqueid":244208,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R33.9","Z87.891","I82.621","L03.113","E87.6","K30","Z79.01","C61","C77.5","Z68.22","Z00.00","R30.0","R73.01","I82.721","Z13.31","D68.59","N30.01","R97.20","Z12.11","Z12.12","R33.8","Z71.3","D72.829","E87.1","R19.5","R11.0","M79.89","R22.31","N48.22","N48.89","I80.8","Z68.20","K57.30","N30.00","R60.0"],"date":["2026-01-30","2026-02-03","2025-05-01","2025-05-01","2025-03-21","2025-03-21","2025-03-21","2026-03-03","2026-02-27","2026-02-27","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-07-15","2025-08-05","2025-10-23","2025-08-12","2025-07-28","2026-01-30","2026-01-30","2025-05-01","2025-05-01","2025-08-12","2025-03-14","2025-03-16","2025-03-16","2026-02-03","2026-02-03","2025-04-09","2025-07-28","2025-08-12","2026-01-29","2025-03-17"],"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":[["","","Ondansetron","4 MG","","Select","Select",""],["","","Clindamycin","300 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Cephalexin","","","Select","Select",""],["","","Bicalutamide","50 MG","","Select","Select",""],["","","Prednisone","5 MG","","Select","Select",""],["","","Abiraterone Acetate","500 MG","","Select","Select",""],["","","Comirnaty 2023-24(12Y Up) Syrg","","","Select","Select",""],["","","0.5 Ml Influenza A Virus A\/Darwin\/9\/2021 H3N2 Antigen","0.03 MG","","Select","Select",""],["","","Flucelvax Trival 2024-2025 Syr","","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Eliquis","","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Sulfamethoxazole","800 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":""}]}]}