{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter Demoore","gend":0,"currentgend":"","add":"PO Box 1199","city":"Dahlonega","state":"GA","zip":30533,"dob":"1966-05-28","age":"","mstatus":"","insh":"0002254105001","cliId":"","pno":7063442095,"cno":7063442095,"email":"lorrydemoore@yahoo.com","ename":"","eno":"","pphy":"John Nelson","ppno":7702198420,"pcpadd":"108 PROMINENCE CT STE 200","pcpcity":"DAWSONVILLE","pcpstate":"GA","pcpzip":30534,"pcpcounty":"","pcpid":"","pcpname":"108 PROMINENCE CT STE 200","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"PO Box 1199","madd2":"","madd3":"","mcity":"Dahlonega","mstate":"GA","mzip":30533,"pcpfaxno":"","pcpnpi":1699120964,"currentgendcomment":"","pphycomment":"","uniqueid":236482,"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":["F41.9","I10","R07.89","R09.89","R09.82","K21.9","R09.81","I13.10","R73.03","E78.2","N18.2","Z12.5","R00.2","I25.10","R06.83","Z09","R93.1","Z00.01","E66.3","F10.21","M15.0","Z12.11","Z68.31","J32.8","Z68.30","J02.9","F10.20","Z13.6","D75.1","Z91.89","Z68.29","J81.1","F41.1","J30.1","R00.1","I11.9","E66.811","Z23","Z68.28","Z00.00","Z13.31","Z71.89","Z13.220","Z13.1","Z13.0","U07.1","J02.0","R52","Z20.828","J30.0","F45.8","M15.9","Z20.822","J06.9","J01.80","K42.9","E66.8","L23.7","E66.9","J32.0","R91.1","J34.2"],"date":["2025-03-14","2024-07-15","2023-10-28","2023-12-04","2024-03-28","2023-12-04","2023-12-04","2026-02-20","2026-01-19","2026-03-02","2026-02-20","2025-07-11","2023-11-20","2026-02-20","2023-11-20","2026-01-19","2026-02-20","2025-07-18","2026-01-19","2026-01-19","2025-07-18","2025-07-18","2025-07-18","2023-11-10","2026-02-20","2025-03-18","2023-11-13","2025-03-14","2023-01-04","2023-11-13","2025-03-18","2023-10-28","2024-03-15","2023-10-02","2024-03-15","2025-03-14","2025-03-14","2026-03-02","2024-07-15","2024-07-15","2023-07-13","2023-07-13","2023-07-13","2023-07-13","2023-07-13","2025-02-24","2025-03-18","2025-02-24","2025-02-24","2024-03-28","2024-03-28","2024-07-15","2025-03-18","2023-01-12","2023-01-12","2023-10-16","2023-11-13","2025-09-22","2023-10-16","2023-10-16","2024-03-15","2023-11-10"],"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":[["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Famotidine","40 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","50 MG","","Select","Select",""],["","","Sertraline","25 MG","","Select","Select",""],["","","Rosuvastatin Calcium","10 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Fluticasone Propionate","0.05 MG","","Select","Select",""],["","","Ipratropium 0.06% Spray","","","Select","Select",""],["","","Losartan Potassium","25 MG","","Select","Select",""],["","","Lorazepam","1 MG","","Select","Select",""],["","","Clonazepam","0.5 MG","","Select","Select",""],["","","Chlorthalidone","25 MG","","Select","Select",""],["","","Potassium Chloride","20 MEQ","","Select","Select",""],["","","Amoxicillin","","","Select","Select",""],["","","Prednisone","10 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":""}]}]}