{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maria Evelyn Melero","gend":1,"currentgend":"","add":"362 Collington Cir","city":"Dalton","state":"GA","zip":30721,"dob":"1968-02-14","age":"","mstatus":"","insh":"0003920879001","cliId":"","pno":7062637165,"cno":7062637165,"email":"mevemel88@gmail.com","ename":"","eno":"","pphy":"Carlos Penaherrera Oviedo","ppno":7062261622,"pcpadd":"215 CURTIS PARKWAY NE","pcpcity":"CALHOUN","pcpstate":"GA","pcpzip":30701,"pcpcounty":"","pcpid":"","pcpname":"215 CURTIS PARKWAY NE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"362 Collington Cir","madd2":"","madd3":"","mcity":"Dalton","mstate":"GA","mzip":30721,"pcpfaxno":7062726445,"pcpnpi":1093268138,"currentgendcomment":"","pphycomment":"","uniqueid":312637,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","1","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E11.69","E66.9","E03.9","R30.0","I49.9","R51.9","M76.61","M92.61","R11.0","T46.4X1","T46.1X1","T38.1X1","T50.0X1","I10","E11.9","Z53.29","M79.7","L73.2","Z86.73","Z90.710","Z88.5","Z91.040","R21","L23.9","S86.011","M19.90","G89.4","E78.5","M25.50","R59.1","R11.2","R50.9","Z90.49","Z87.891","E66.8","K63.89","N30.01","E87.6","R00.2","R42","R53.1","R07.89","Z87.442","K57.90","Z87.19","Z91.048","Z79.82","Z79.4","N30.00","K57.32","E78.49","K57.92","F43.9","M54.50","L70.9","G89.29","E83.42","F32.A","M21.6X1","G89.18","R55","E55.9","Z79.85","S86.112","M72.2","Z12.31","Z03.818","R68.89","R50.81","E66.89","M54.59","Z12.11","Z12.12","L97.411","M62.830","L25.9","M25.562","T50.901","E11.59","J45.20","M77.9","E66.01","D64.9","G56.03","M25.561","K21.9","R10.13","K59.00","R19.7","Z68.41","E11.65","M13.0","Z79.84","Z79.890","Z79.899","Z91.199","I82.401","L97.511","L71.9","L30.9","E11.621","L23.89","L20.89","M89.8X7","R10.32","M17.12","R07.9","Z13.6","M79.661","M25.531","F43.0","K76.0","R94.31","I23.1","F41.9"],"date":["2025-08-18","2026-02-16","2025-08-18","2024-09-14","2025-03-08","2025-03-08","2024-08-30","2024-08-30","2024-09-28","2023-09-28","2023-09-28","2023-09-28","2023-09-28","2025-08-18","2026-02-16","2023-09-28","2025-02-02","2023-09-28","2025-03-09","2025-02-02","2024-08-11","2024-08-11","2025-08-18","2025-06-29","2024-03-20","2024-04-23","2023-09-27","2024-04-23","2023-09-27","2025-01-29","2025-01-29","2025-01-29","2025-02-02","2025-03-09","2024-06-10","2025-02-02","2024-10-05","2025-03-11","2025-03-11","2025-03-24","2025-03-11","2025-03-09","2025-03-09","2024-08-11","2024-12-30","2024-08-11","2025-02-02","2024-08-11","2024-10-01","2025-02-13","2025-08-18","2025-02-07","2024-09-28","2024-10-01","2024-10-01","2024-10-01","2025-03-11","2024-04-23","2024-03-07","2024-03-07","2024-10-15","2025-08-18","2024-12-30","2024-01-22","2024-03-07","2025-04-23","2024-01-10","2024-01-10","2024-01-10","2024-10-21","2023-12-20","2025-06-19","2025-06-19","2024-05-22","2024-08-31","2024-08-31","2024-05-13","2023-09-28","2023-09-18","2023-09-18","2023-09-18","2025-02-02","2023-09-27","2025-02-07","2023-09-18","2023-09-27","2023-09-27","2023-09-27","2023-09-27","2025-02-02","2025-02-02","2025-02-02","2025-02-02","2025-02-02","2025-02-02","2025-02-02","2024-06-12","2024-04-17","2025-11-11","2025-11-11","2024-04-17","2024-05-01","2024-05-01","2024-03-07","2025-01-29","2024-05-13","2025-03-11","2025-03-11","2024-04-09","2024-04-02","2024-09-28","2024-08-11","2025-02-03","2025-02-03","2025-02-07"],"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","25 MG","","Select","Select",""],["","","Levothyroxine","125 MCG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","5 MG","","Select","Select",""],["","","Duloxetine","30 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","50 MG","","Select","Select",""],["","","Oxycodone-Acetaminophen 5-325","","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","150 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Dexcom G6 Sensor","","","Select","Select",""],["","","Ozempic 0.25-0.5 Mg\/Dose Pen","","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Celecoxib","200 MG","","Select","Select",""],["","","Lisinopril","40 MG","","Select","Select",""],["","","Ozempic","1 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.15 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","Mounjaro","","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Clobetasol Propionate","0.5 MG","","Select","Select",""],["","","Minocycline","100 MG","","Select","Select",""],["","","Betamethasone","0.5 MG","","Select","Select",""],["","","Dexcom G7 15 Day Sensor","","","Select","Select",""],["","","Hydrocortisone","10 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Nitrofurantoin, Macrocrystals","25 MG","","Select","Select",""],["","","Meloxicam","15 MG","","Select","Select",""],["","","Metoclopramide","10 MG","","Select","Select",""],["","","Tacrolimus","0.001 MG","","Select","Select",""],["","","Ofloxacin","","","Select","Select",""],["","","Prednisone","50 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":""}]}]}