{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeff Murray","gend":0,"currentgend":"","add":"95 Autumn Ln","city":"Cleveland","state":"GA","zip":30528,"dob":"1978-05-11","age":"","mstatus":"","insh":"0002255582002","cliId":"","pno":7068090833,"cno":7068090833,"email":"","ename":"","eno":"","pphy":"Ayham Haddad","ppno":7705320800,"pcpadd":"142 PARKWAY PLZ","pcpcity":"CLEVELAND","pcpstate":"GA","pcpzip":30528,"pcpcounty":"","pcpid":"","pcpname":"142 PARKWAY PLZ","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"95 Autumn Ln","madd2":"","madd3":"","mcity":"Cleveland","mstate":"GA","mzip":30528,"pcpfaxno":7705320801,"pcpnpi":1952398406,"currentgendcomment":"","pphycomment":"","uniqueid":249637,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I25.118","E78.2","I10","E78.5","J40","Z00.01","R79.89","K21.9","F41.9","Q64.32","D22.9","F17.210","Z68.29","R07.9","R93.1","Z68.28","I11.9","Z79.899","Z79.82","Z79.02","Z82.49","M54.41","M16.11","M25.551","G89.29","I70.8","R94.30","Z95.1","J01.90","M51.16","M43.16","N20.0","N13.5","E29.1","Z13.89","Z00.00","S91.331","Z23","U07.1","Z20.822","Z20.828","R11.2","I25.10","Z68.31","R07.2","Z72.0","R63.8","M48.061","M51.17","M47.27","I25.810","Z68.30","Z12.83","L30.4","L72.0","L82.1","L56.8","W89.1XX","Z71.89","R05.1","R07.0","R09.81","R50.9","I65.23","Z09","Z98.890","J81.1","J98.11","J03.00","G89.4","Z01.810","R91.8","J10.08","J02.9","Z01.818","R00.1"],"date":["2025-11-18","2026-02-09","2025-07-14","2025-07-14","2024-04-23","2024-04-23","2025-04-21","2025-06-19","2025-07-16","2024-04-23","2024-04-23","2025-07-16","2024-04-23","2025-06-23","2025-09-05","2025-08-04","2026-02-09","2025-07-16","2025-07-16","2025-07-16","2025-07-16","2025-05-19","2025-05-19","2025-05-27","2025-05-20","2025-06-24","2025-09-05","2025-11-25","2025-12-23","2025-06-16","2025-04-28","2024-03-12","2024-03-12","2024-03-12","2025-04-21","2025-04-28","2023-10-09","2023-10-09","2024-01-13","2024-01-13","2024-01-13","2024-01-13","2026-02-09","2026-02-09","2025-06-19","2025-06-19","2025-06-19","2025-06-16","2025-11-13","2025-06-16","2025-11-25","2025-11-18","2024-07-10","2024-07-10","2024-07-10","2024-07-10","2024-07-10","2024-07-10","2024-07-10","2024-01-13","2026-01-27","2024-01-13","2024-01-13","2025-07-03","2025-07-22","2025-07-16","2025-07-16","2025-07-16","2026-01-27","2025-05-27","2025-07-01","2025-07-01","2024-01-02","2024-01-02","2025-07-08","2025-11-25"],"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":[["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Baloxavir Marboxil","80 MG","","Select","Select",""],["","","Paxlovid 300-100 Mg Dose Pack","","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Tadalafil","5 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Rosuvastatin Calcium","20 MG","","Select","Select",""],["","","Amiodarone Hydrochloride","200 MG","","Select","Select",""],["","","Clopidogrel","75 MG","","Select","Select",""],["","","Methylprednisolone","4 MG","","Select","Select",""],["","","Temazepam","","","Select","Select",""],["","","24 Hr Isosorbide Mononitrate","30 MG","","Select","Select",""],["","","Nitroglycerin","0.4 MG","","Select","Select",""],["","","Prasugrel","10 MG","","Select","Select",""],["","","Cefuroxime","500 MG","","Select","Select",""],["","","{11 Varenicline","0.5 MG","","Select","Select",""],["","","Mupirocin","","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Metoprolol Tartrate","50 MG","","Select","Select",""],["","","Diazepam","","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Amox-Clav 875-125 Mg Tablet","","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","24 Hr Nicotine","0.875 MG","","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":""}]}]}