{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Anissa Colbert","gend":1,"currentgend":"","add":"1481 Forest Hill Rd Apt 201","city":"Macon","state":"GA","zip":"31210","dob":"1969-08-17","age":"","mstatus":"","insh":"0003634731001","cliId":"","pno":"4783904861","cno":"4785387928","email":"anissa3200@gmail.com","ename":"","eno":"","pphy":"Frederick Burton","ppno":"4784718593","pcpadd":"210 MERCER JCT","pcpcity":"MACON","pcpstate":"GA","pcpzip":"31210","pcpcounty":"","pcpid":"","pcpname":"210 MERCER JCT","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1481 Forest Hill Rd Apt 201","madd2":"","madd3":"","mcity":"Macon","mstate":"GA","mzip":"31210","pcpfaxno":"4784718599","pcpnpi":"1912947326","currentgendcomment":"","pphycomment":"","uniqueid":"323669","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":["I34.0","E55.9","K21.9","G43.909","G89.29","E53.8","F51.01","F41.9","I10","T88.59X","R47.82","I05.9","E66.811","I34.1","Z90.710","Z79.899","Z88.5","Z88.8","Z68.31","Z87.891","Z82.49","R00.2","R73.03","Z68.32","Z68.30","I67.1","K76.0","I51.7","I34.81","I70.8","N28.1","R22.2","R53.1","M54.9","F80.81","Z71.82","Z91.81","Z13.89","R29.898","M17.12","M17.11","R29.90","M25.562","R41.82","R49.1","Z01.810","M25.569","R41.3","I07.1","I63.9","G43.009","I38","Z53.20","R47.89","Z86.69","I47.20","I49.3","R55","R56.9","R29.818"],"date":["2026-07-23","2026-07-14","2026-07-14","2026-07-14","2026-07-14","2026-07-14","2026-07-14","2026-07-14","2026-07-14","2026-04-30","2026-04-30","2026-08-12","2026-04-28","2026-07-23","2026-04-28","2026-04-28","2026-04-28","2026-04-28","2026-04-28","2026-04-28","2026-04-28","2026-05-19","2026-05-19","2026-05-19","2026-02-10","2026-06-24","2026-07-23","2026-07-23","2026-07-23","2026-07-23","2026-07-23","2026-03-26","2026-06-15","2026-06-15","2026-06-15","2026-06-15","2026-06-15","2026-06-15","2026-06-10","2026-03-31","2026-03-31","2026-05-01","2026-03-31","2026-04-28","2026-05-02","2026-04-28","2026-05-05","2026-06-24","2026-03-16","2026-04-29","2026-06-24","2026-04-15","2026-05-01","2026-04-28","2026-04-28","2026-04-14","2026-04-14","2026-04-14","2026-04-28","2026-04-28"],"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":[["","","AMITRIPTYLINE HYDROCHLORIDE","25000 MG","","Select","Select",""],["","","CYANOCOBALAMIN","1000000 MCG\/ML","","Select","Select",""],["","","FUROSEMIDE","40000 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50000 MG","","Select","Select",""],["","","RIZATRIPTAN BENZOATE ODT","10000 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40000 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10000 MEQ","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4000 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","5000 MG","","Select","Select",""],["","","ZOLPIDEM TARTRATE","10000 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","50000 MG","","Select","Select",""],["","","AJOVY","225000 MG\/1.5ML","","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":""}]}]}