{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Helen Allen","gend":1,"currentgend":"","add":"183 Geise St S","city":"Bronwood","state":"GA","zip":"39826","dob":"1962-03-18","age":"","mstatus":"","insh":"0003797495001","cliId":"","pno":"2292882240","cno":"2292882240","email":"eddieallen560@gmail.com","ename":"","eno":"","pphy":"Gurinder Doad","ppno":"2562284166","pcpadd":"2336 DAWSON RD STE 1500","pcpcity":"ALBANY","pcpstate":"GA","pcpzip":"31707","pcpcounty":"","pcpid":"","pcpname":"2336 DAWSON RD STE 1500","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"183 Geise St S","madd2":"","madd3":"","mcity":"Bronwood","mstate":"GA","mzip":"39826","pcpfaxno":"2562284186","pcpnpi":"1134117591","currentgendcomment":"","pphycomment":"","uniqueid":"333159","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":["R07.9","I08.1","R94.31","M25.552","M25.561","M25.562","M79.641","M79.642","G89.29","W18.39X","R06.00","I50.33","G43.909","Z04.3","M18.12","M18.11","M16.11","R07.89","I10","E11.9","R10.A1","R30.0","K59.09","I11.0","I48.0","I25.2","Z86.73","R00.0","R00.2","R60.0","I83.813","R51.9"],"date":["2026-07-25","2026-04-03","2026-07-25","2026-04-18","2026-04-18","2026-04-18","2026-04-18","2026-04-18","2026-04-18","2026-04-18","2026-03-18","2026-07-25","2026-07-25","2026-04-18","2026-04-18","2026-04-18","2026-04-18","2026-04-03","2026-04-03","2026-03-24","2026-03-24","2026-03-24","2026-03-24","2026-07-25","2026-03-10","2026-03-10","2026-03-10","2026-03-10","2026-03-10","2026-03-10","2026-01-12","2026-07-25"],"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":[["","","DEXCOM G","0","","Select","Select",""],["","","METOCLOPRAMIDE HYDROCHLORIDE","5000 MG","","Select","Select",""],["","","BACLOFEN","10000 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","0","","Select","Select",""],["","","DAPAGLIFLOZIN","5000 MG","","Select","Select",""],["","","FUROSEMIDE","40000 MG","","Select","Select",""],["","","EZETIMIBE","10000 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25000 MG","","Select","Select",""],["","","IBUPROFEN","600000 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":""}]}]}