{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Natalie Renee Bryson","gend":1,"currentgend":"","add":"1766 Zeb Bryson Rd","city":"Clarkesville","state":"GA","zip":30523,"dob":"1963-03-26","age":"","mstatus":"","insh":"0003886554001","cliId":"","pno":7063483087,"cno":7063483087,"email":"natalie.enterprise@gmail.com","ename":"","eno":"","pphy":"Nitya Chandra","ppno":7705342020,"pcpadd":"743 SPRING ST NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013715,"pcpcounty":"","pcpid":"","pcpname":"743 SPRING ST NE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1766 Zeb Bryson Rd","madd2":"","madd3":"","mcity":"Clarkesville","mstate":"GA","mzip":30523,"pcpfaxno":7705348025,"pcpnpi":1013197995,"currentgendcomment":"","pphycomment":"","uniqueid":289142,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R79.89","G89.18","K21.9","I10","Z82.49","F32.A","E11.9","Z86.73","Z85.3","Z92.3","M19.90","N64.4","Z79.811","Z79.899","Z90.13","Z90.49","Z91.030","M48.061","N39.0","E87.6","M54.16","Z90.11","C50.811","D50.9","M43.16","M48.062","M54.17","M51.369","Z79.84","N28.89","N28.1","T81.89X","K76.0","Z79.01","I82.621","I50.20","R91.8","N28.9","N61.0","Z68.38","I11.9","C50.911","Z13.31","C50.912","Z68.33","Z17.0","Z80.8","T81.30X","L76.82","S21.002","Z68.31","M25.60","M62.81","G93.89","N64.89","C50.812","R42","F33.0","Z68.34","I69.398","Z78.0","Z86.718","Z68.35","L90.5","R10.11","Z53.21","I11.0","I42.7","I50.30","I82.629","C50.919","F41.9","Z68.37","Z51.81","Z01.818","E66.811","C44.519","T85.41X","C44.622","I82.A11","Z42.1","L72.0","R10.9","R10.31","C44.41","Z09","R00.1","R60.0","C50.312","Z12.11","Z80.2","M51.17","M43.17","M51.27","M51.360","M47.816","M51.24","M47.814","D48.5","N65.0","L76.33","M79.671"],"date":["2024-01-03","2023-10-25","2025-11-20","2025-11-20","2023-08-28","2023-08-28","2025-11-20","2025-11-20","2026-02-24","2023-08-28","2023-08-28","2023-08-28","2026-02-03","2025-09-23","2026-02-24","2023-08-28","2023-08-28","2025-09-23","2025-08-21","2026-02-03","2025-11-25","2023-05-14","2026-02-03","2024-01-03","2025-11-26","2025-12-11","2025-11-26","2025-11-26","2025-11-26","2025-08-14","2025-08-14","2023-08-27","2023-08-18","2024-01-03","2024-01-03","2024-01-03","2024-01-03","2023-03-29","2023-09-20","2023-01-31","2023-01-31","2026-02-03","2024-07-31","2024-07-31","2025-11-20","2024-07-31","2026-02-03","2023-08-27","2026-02-24","2023-09-20","2025-10-31","2025-10-01","2025-10-01","2025-08-28","2023-09-20","2025-05-06","2025-08-28","2025-05-06","2025-05-06","2025-05-06","2026-02-03","2025-11-20","2024-01-03","2023-08-21","2025-08-14","2025-08-14","2023-05-10","2025-11-20","2023-05-10","2023-01-31","2023-01-31","2023-05-10","2023-07-26","2023-05-10","2025-11-20","2025-11-20","2023-04-19","2026-02-24","2025-06-02","2023-03-22","2023-08-15","2024-01-23","2025-08-20","2025-08-14","2024-01-31","2026-01-08","2025-08-14","2024-09-24","2026-02-03","2026-02-03","2026-02-03","2025-10-31","2025-10-31","2025-08-21","2025-08-21","2025-08-21","2025-08-21","2025-08-21","2025-05-27","2024-11-15","2023-08-28","2024-09-24"],"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":[["","","Amlodipine","10 MG","","Select","Select",""],["","","Eliquis","5 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Letrozole","2.5 MG","","Select","Select",""],["","","Prednisone","5 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Ibuprofen","600 MG","","Select","Select",""],["","","Anastrozole","1 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Enoxaparin","40 MG","","Select","Select",""],["","","Carvedilol","12.5 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Prochlorperazine","10 MG","","Select","Select",""],["","","Oxycodone-Acetaminophen 10-325","","","Select","Select",""],["","","Duloxetine","30 MG","","Select","Select",""],["","","Rosuvastatin Calcium","20 MG","","Select","Select",""],["","","Oxycodone-Acetaminophn 7.5-325","","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Hydrochlorothiazide","25 MG","","Select","Select",""],["","","Doxycycline Mono","100 MG","","Select","Select",""],["","","Ozempic","1 MG","","Select","Select",""],["","","Nda021457 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Mounjaro","10 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Jardiance","10 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Diazepam","","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","Cephalexin","","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Omeprazole Dr","20 MG","","Select","Select",""],["","","Promethazine Hydrochloride","12.5 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Potassium Chloride","10 MEQ","","Select","Select",""],["","","Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Ozempic 0.25-0.5 Mg\/Dose Pen","","","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":""}]}]}