{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kirstyn LINDSEY Canington","gend":1,"currentgend":"","add":"3000 Clarks Bridge Rd Lot 31","city":"Gainesville","state":"GA","zip":"30501","dob":"1991-02-21","age":"","mstatus":"","insh":"0004077702001","cliId":"","pno":"6783164282","cno":"6783164282","email":"misakiyukilover@gmail.com","ename":"","eno":"","pphy":"Huma Sohail","ppno":"7705313711","pcpadd":"700 S ENOTA DR NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":"30501","pcpcounty":"","pcpid":"","pcpname":"700 S ENOTA DR NE","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"3000 Clarks Bridge Rd Lot 31","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":"30501","pcpfaxno":"7705313718","pcpnpi":"1053527275","currentgendcomment":"","pphycomment":"","uniqueid":"272257","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":["R52","T14.90X","J06.9","Z20.828","Z20.818","Z68.35","M25.551","M54.12","M62.81","R26.2","M54.50","M54.17","M54.2","V89.2XX","Z04.1","L40.0","M47.897","L13.0","S46.092","S16.1XX","G44.89","M25.571","M25.572","M76.822","G43.109","Z68.36","M62.838","E66.9","G43.709","I10","F33.1","F41.0","F51.01","F43.10","Z12.11","Z86.010"],"date":["2026-02-17","2026-04-27","2026-02-17","2026-02-17","2026-02-17","2026-02-17","2026-06-30","2026-06-30","2026-06-30","2026-06-30","2023-01-31","2026-07-21","2026-03-06","2026-03-06","2026-04-27","2026-04-29","2026-04-29","2026-04-29","2026-04-29","2026-04-27","2026-04-27","2026-02-25","2026-02-25","2026-02-25","2026-05-15","2026-02-09","2026-07-21","2023-01-12","2026-05-15","2026-05-15","2026-06-04","2026-06-04","2026-06-04","2026-06-04","2026-04-20","2026-04-20"],"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":[["","","BENZONATATE","200 MG","","Select","Select",""],["","","TOPIRAMATE","25000 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","60000 MG","","Select","Select",""],["","","DAPSONE","100000 MG","","Select","Select",""],["","","PREGABALIN","75000 MG","","Select","Select",""],["","","SULFASALAZINE","500000 MG","","Select","Select",""],["","","EMGALITY","120000 MG\/ML","","Select","Select",""],["","","LISINOPRIL","10000 MG","","Select","Select",""],["","","PREDNISONE","10000 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","DILTIAZEM","240 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","100 %","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","75000 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","DILTIAZEM HYDROCHLORIDE ER","120000 MG","","Select","Select",""],["","","RINVOQ","15000 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":""}]}]}