{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Amanda Lynn Starrett","gend":1,"currentgend":"","add":"2044 Chestnut Gap Rd Apt 1","city":"Blue Ridge","state":"GA","zip":30513,"dob":"1984-08-13","age":"","mstatus":"","insh":"0003924397001","cliId":"","pno":7066336430,"cno":7066336430,"email":"amanda.sanders28@yahoo.com","ename":"","eno":"","pphy":"Mwamba Mwila","ppno":4043673014,"pcpadd":"1255 HIGHWAY 54 W","pcpcity":"FAYETTEVILLE","pcpstate":"GA","pcpzip":30214,"pcpcounty":"","pcpid":"","pcpname":"1255 HIGHWAY 54 W","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"2044 Chestnut Gap Rd Apt 1","madd2":"","madd3":"","mcity":"Blue Ridge","mstate":"GA","mzip":30513,"pcpfaxno":"","pcpnpi":1629427570,"currentgendcomment":"","pphycomment":"","uniqueid":298300,"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":["D64.9","E11.359","R91.8","M79.641","M79.642","M25.511","M54.2","R10.2","R06.02","N93.0","E11.351","D63.8","N17.9","E10.43","M06.4","E66.812","E06.3","I10","J45.909","Z79.4","K31.84","M79.7","E78.5","K21.9","K58.9","Z88.0","Z88.5","Z79.84","Z79.890","Z68.37","Z79.51","Z79.52","Z79.899","Z87.891","Z11.52","J32.1","J34.2","J33.9","E10.65","E03.8","M25.50","R20.0","E10.9","E13.9","J32.9","R09.82","R49.0","R09.81","R06.83","G47.10","N95.1","Z13.6","E10.42","E88.819","H81.10","R29.810","Z96.41","Z87.11","R20.2","E88.81","Z01.89","R51.9","J32.0","K65.4","R10.9","H25.13","J20.8","J01.80","D84.9","M65.331","L91.0","D50.0","N92.1","Z20.822","R05.1","B96.89","Z76.0","I49.8","R07.89","R13.19","T18.2XX","K20.80","J32.8","J32.2","J34.89","J02.9","J02.8","R21","N39.0","G56.03","E66.01","G56.02","G56.01","Z32.02","Z01.419","Z11.51","Z01.818","Z72.0","R05.3","R06.2","R40.0","G47.33","J18.9","M35.1","K59.09","R10.A1","R07.9","R05.9","M54.50","R30.0","R29.818","Z80.3","M79.18","J20.9","J10.89","S05.02X","M65.341","M75.51","L82.0","L53.8","L29.8","L30.4","M75.01","M65.311","M75.20","Z74.3","G50.1","J30.1","J30.89","J30.81","J33.8","K63.89","Z86.39","Z83.79","G43.109","G45.9","R42","R13.10","M25.60","M25.40","J06.9","Z87.09","B37.31","J32.4","E66.3","J01.10","H43.11","H35.372","E08.359","R53.1","G43.909","E11.9","E03.9","I82.409","D48.5","K62.89","M79.10","R50.9","J01.90","J98.4","I47.10","Z12.31","Z86.16","J10.1","N83.201","N83.202","D50.8","E11.65","M35.9","N18.30","E78.49","F32.89","R19.5","F32.A","F33.1","E10.329","M54.12","E66.9","Z68.34","Z15.09"],"date":["2026-03-04","2024-07-23","2023-06-29","2025-08-04","2025-08-04","2026-03-17","2025-08-04","2025-08-21","2026-01-29","2025-09-04","2025-12-11","2026-01-24","2026-01-29","2026-01-23","2026-01-23","2026-01-23","2026-03-02","2026-01-24","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2026-01-23","2024-08-26","2024-07-26","2024-07-26","2026-03-02","2025-04-14","2025-10-06","2024-04-04","2026-01-24","2025-10-28","2024-07-29","2024-03-14","2024-03-14","2024-10-02","2024-08-26","2024-03-14","2025-05-21","2024-03-10","2024-03-10","2024-03-10","2024-03-10","2024-03-10","2024-03-10","2024-03-10","2024-04-04","2023-09-26","2023-04-17","2024-03-10","2024-10-02","2024-11-13","2024-11-14","2025-12-11","2025-04-14","2026-02-03","2025-04-14","2025-04-30","2024-01-02","2026-03-04","2026-03-04","2023-06-04","2025-10-10","2025-10-06","2023-03-20","2024-05-10","2026-01-24","2025-02-05","2025-02-05","2025-02-05","2024-05-24","2024-08-26","2024-05-24","2025-10-10","2025-10-06","2025-10-06","2026-02-19","2025-04-30","2025-04-30","2025-04-30","2025-04-30","2025-09-04","2025-05-22","2025-05-22","2024-07-08","2023-02-24","2023-06-08","2023-02-24","2023-02-24","2023-02-24","2023-02-24","2026-01-29","2026-01-29","2026-02-11","2026-01-24","2024-11-14","2024-11-04","2024-11-04","2024-03-10","2025-05-21","2023-06-04","2023-06-04","2023-06-04","2024-06-18","2025-03-28","2025-03-28","2024-01-02","2024-01-02","2024-01-02","2023-11-15","2026-02-23","2026-02-23","2025-12-12","2026-01-23","2024-10-02","2024-10-02","2024-10-02","2024-10-02","2024-10-02","2024-11-25","2024-11-25","2024-11-25","2024-03-15","2024-03-15","2024-03-15","2024-03-15","2025-02-19","2025-02-19","2025-10-10","2025-10-10","2025-10-10","2024-06-21","2026-01-24","2023-04-17","2024-07-22","2024-07-22","2024-07-22","2024-03-10","2024-03-10","2024-03-10","2025-02-05","2024-03-10","2023-12-19","2025-06-10","2023-02-16","2023-02-16","2024-07-26","2024-03-10","2025-02-05","2025-05-30","2023-08-04","2023-08-04","2025-08-11","2025-08-11","2026-02-03","2026-02-03","2026-02-03","2026-02-03","2025-04-07","2025-04-07","2025-06-10","2025-05-05","2025-05-05","2023-08-16","2025-10-01","2025-02-05","2025-02-05","2025-05-21"],"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":[["","","Levothyroxine Sodium","0.088 MG","","Select","Select",""],["","","24 Hr Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","Levofloxacin","500 MG","","Select","Select",""],["","","Toujeo Solostar 300 Unit\/Ml","","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","Flovent Hfa","110 MCG","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","Humalog 100 Unit\/Ml Cartridge","","","Select","Select",""],["","","Nadolol","20 MG","","Select","Select",""],["","","Dexcom G6 Sensor","","","Select","Select",""],["","","Omnipod 5 G6 Intro Kit (Gen 5)","","","Select","Select",""],["","","Dexcom G6 Transmitter","","","Select","Select",""],["","","Insulin Lispro 100 Unit\/Ml Vl","","","Select","Select",""],["","","Omnipod 5 G6 Pods (Gen 5) 5Pk","","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","Novolog 100 Unit\/Ml Vial","","","Select","Select",""],["","","Losartan Potassium","25 MG","","Select","Select",""],["","","Montelukast","10 MG","","Select","Select",""],["","","Cefuroxime","250 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 Mg","","","Select","Select",""],["","","Clindamycin","300 MG","","Select","Select",""],["","","Prednisone","50 MG","","Select","Select",""],["","","Ketorolac Tromethamine","10 MG","","Select","Select",""],["","","Relion Novolog 100 Unit\/Ml Vl","","","Select","Select",""],["","","Omnipod 5 Dexg7G6 Pods (Gen 5)","","","Select","Select",""],["","","Novolog Relion","","","Select","Select",""],["","","Omnipod 5 Dexcom G7G6 Pods (Gen 5)","","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Pregabalin","50 MG","","Select","Select",""],["","","Epinephrine","0.3 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Ipratropium Bromide\/Albuterol Sulfate","","","Select","Select",""],["","","Amitriptyline Hydrochloride","25 MG","","Select","Select",""],["","","Celecoxib","200 MG","","Select","Select",""],["","","Methotrexate Sodium","","","Select","Select",""],["","","Folic Acid","1 MG","","Select","Select",""],["","","Nitroglycerin","0.4 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Toujeo Max Solostr 300 Unit\/Ml","","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Nda020503 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Trelegy Ellipta 200-62.5-25","","","Select","Select",""],["","","Triamcinolone Acetonide","0.25 MG","","Select","Select",""],["","","Rosuvastatin Calcium","5 MG","","Select","Select",""],["","","Ofloxacin","3 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Acetaminophen","300 MG","","Select","Select",""],["","","Nda021457 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Fluconazole","150 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":""}]}]}