{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert Lee English","gend":0,"currentgend":"","add":"5670 Pipsissewa Dr","city":"Flowery Branch","state":"GA","zip":30542,"dob":"1969-04-20","age":"","mstatus":"","insh":"0003787262001","cliId":"","pno":6783165810,"cno":6783165811,"email":"kimenglish20@gmail.com","ename":"","eno":"","pphy":"Kyle Castleberry","ppno":9124276811,"pcpadd":"1400 RIVER PLACE","pcpcity":"BRASELTON","pcpstate":"GA","pcpzip":30517,"pcpcounty":"","pcpid":"","pcpname":"1400 RIVER PLACE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"5670 Pipsissewa Dr","madd2":"","madd3":"","mcity":"Flowery Branch","mstate":"GA","mzip":30542,"pcpfaxno":"","pcpnpi":1417705450,"currentgendcomment":"","pphycomment":"","uniqueid":278484,"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":["Z90.5","Z87.891","C79.89","Z85.528","N20.0","Z00.00","Z13.1","E55.9","Z13.29","D63.1","N18.2","T14.8XX","R22.2","Z68.24","D49.511","I82.220","S39.012","Z48.01","R39.89","T81.31X","K59.03","R94.31","C64.1","Z68.25","N40.1","T40.2X5","Z98.890","C64.9","Z13.220","Z12.5","K51.019","J98.4","K57.30","N28.1","D63.8","Z76.89","K51.90","R03.0","Z68.23","Z80.9","T78.40X","W57.XXX","C77.5","R19.00","Z01.818","C79.01","S31.000","Z46.6","K51.919","S21.209","M51.34","M51.360","N50.9","M79.89","R22.30","A60.02","Z68.20","S21.201","D49.2","M54.9","T81.89X","U07.1","R31.29","R10.9","E66.3","Z45.2","M54.41"],"date":["2026-03-12","2026-03-13","2026-03-12","2026-03-12","2024-07-17","2026-01-21","2026-01-21","2026-01-21","2026-01-21","2024-07-17","2024-07-17","2026-03-13","2026-01-28","2026-01-15","2026-01-20","2026-03-01","2024-12-04","2026-02-12","2023-01-19","2026-01-29","2025-12-20","2025-12-19","2026-03-18","2026-02-23","2024-01-29","2025-12-20","2025-12-20","2025-12-29","2026-01-20","2026-01-20","2026-01-20","2023-05-22","2023-05-22","2023-05-22","2023-01-19","2023-01-19","2024-12-17","2023-12-29","2024-12-17","2024-12-17","2024-07-10","2024-07-10","2026-02-23","2025-09-05","2025-12-05","2025-10-01","2026-02-10","2023-01-17","2024-12-17","2026-01-22","2025-11-23","2025-11-23","2023-09-05","2025-12-29","2025-09-05","2023-12-29","2023-01-19","2026-03-13","2025-12-04","2025-12-04","2026-01-27","2025-03-06","2023-06-08","2025-12-19","2023-12-29","2025-11-03","2025-09-05"],"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":[["","","Phenazopyridine Hydrochloride","200 MG","","Select","Select",""],["","","Balsalazide Disodium","750 MG","","Select","Select",""],["","","Valacyclovir","500 MG","","Select","Select",""],["","","Epinephrine","0.3 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","5 MG","","Select","Select",""],["","","Nda019430","0.3 ML","","Select","Select",""],["","","Tramadol Hydrochloride","","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 7.5-325","","","Select","Select",""],["","","Paxlovid","","","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":""}]}]}