{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Yasmin Deshields","gend":1,"currentgend":"","add":"901 Jolly Ct","city":"Albany","state":"GA","zip":"31701","dob":"1975-04-28","age":"","mstatus":"","insh":"0003672572001","cliId":"","pno":"3024162221","cno":"4787441511","email":"mstoyab28@icloud.com","ename":"","eno":"","pphy":"Maryam Sedghi","ppno":"4786335500","pcpadd":"3780 EISENHOWER PKWY","pcpcity":"MACON","pcpstate":"GA","pcpzip":"31206","pcpcounty":"","pcpid":"","pcpname":"3780 EISENHOWER PKWY","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"901 Jolly Ct","madd2":"","madd3":"","mcity":"Albany","mstate":"GA","mzip":"31701","pcpfaxno":"4787845496","pcpnpi":"1730124843","currentgendcomment":"","pphycomment":"","uniqueid":"337333","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":["M32.9","D50.8","K90.9","E11.40","M06.00","Z91.199","Z79.69","Z79.52","Z79.631","D50.9","Z11.59","G62.9","J31.0","Z28.21","Z12.11","J45.901","D72.829","I82.409","M32.10","B97.89","Z79.01","Z79.899","J45.41","Z11.4","R06.03","R06.00","R00.0","I49.3"],"date":["2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-02-06","2026-03-05","2026-02-06","2026-02-06","2026-02-06","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-16","2026-04-15","2026-02-06","2026-04-14","2026-04-14","2026-04-14","2026-04-14"],"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":[["","","PREDNISONE","5000 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","20000 MG","","Select","Select",""],["","","LEFLUNOMIDE","10000 MG","","Select","Select",""],["","","NITROFURANTOIN MONOHYDRATE\/MACROCRYSTALS","100000 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50000 MCG\/ACT","","Select","Select",""],["","","FOLIC ACID","1000 MG","","Select","Select",""],["","","SYMBICORT","0","","Select","Select",""],["","","METHOTREXATE SODIUM","2500 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":""}]}]}