{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Chuong Dinh Ngo","gend":0,"currentgend":"","add":"2248 Rocky Face Cir","city":"Dalton","state":"GA","zip":30720,"dob":"1964-08-30","age":"","mstatus":"","insh":"0002442191001","cliId":"","pno":7064591119,"cno":7064591119,"email":"naphuong89@gmail.com","ename":"","eno":"","pphy":"Natalie Bessom","ppno":7062269355,"pcpadd":"1107 MEMORIAL DR STE 200","pcpcity":"DALTON","pcpstate":"GA","pcpzip":30720,"pcpcounty":"","pcpid":"","pcpname":"1107 MEMORIAL DR STE 200","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"2248 Rocky Face Cir","madd2":"","madd3":"","mcity":"Dalton","mstate":"GA","mzip":30720,"pcpfaxno":7062269380,"pcpnpi":1235517137,"currentgendcomment":"","pphycomment":"","uniqueid":250400,"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":["C61","I15.9","I63.9","R78.81","E87.20","I10","E87.1","Z16.12","N17.9","E87.6","B96.20","F17.210","E78.5","N40.0","Z60.3","Z85.46","Z86.73","K59.00","R53.1","Z98.890","N30.01","R91.8","R97.20","D51.0","E55.9","Z12.11","Z12.2","Z23","Z00.00","Z13.1","Z12.5","D64.9","F17.200","R33.9","Z79.02","A49.8","R30.0","R94.2","R94.31","Z13.6","Z87.440","N39.0","A41.9","K83.8","N32.89","Z87.891","Z79.899","I45.81","I44.0","R91.1","J43.9","A41.51","N41.0","R68.83","R50.9","R79.89","N30.00","Z72.0","R10.9"],"date":["2026-01-20","2025-10-06","2025-04-15","2024-12-31","2024-12-23","2024-12-19","2024-12-31","2024-12-26","2024-12-19","2024-12-23","2024-12-19","2025-01-07","2024-12-19","2024-12-19","2024-12-19","2024-12-19","2025-01-07","2024-12-19","2024-12-19","2024-12-21","2025-01-08","2025-06-16","2025-06-16","2024-10-21","2024-10-21","2024-10-21","2024-12-10","2024-10-21","2024-10-21","2024-10-21","2024-10-21","2025-01-07","2023-11-07","2024-11-19","2024-11-19","2024-12-26","2025-01-07","2025-06-16","2024-12-19","2024-12-19","2025-01-07","2025-01-07","2024-12-18","2024-12-18","2024-12-18","2025-06-16","2023-11-07","2024-12-19","2024-12-19","2026-02-10","2026-02-10","2025-01-13","2025-01-13","2024-12-19","2024-12-19","2024-12-20","2024-12-23","2024-12-23","2025-01-08"],"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":[["","","Clopidogrel","75 MG","","Select","Select",""],["","","Lisinopril","5 MG","","Select","Select",""],["","","Rosuvastatin Calcium","20 MG","","Select","Select",""],["","","Fosfomycin","3000 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Cefdinir","300 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":""}]}]}