{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Keller Christopher Green","gend":0,"currentgend":"","add":"989 Wilson Rd","city":"Mount Airy","state":"GA","zip":30563,"dob":"2005-05-29","age":"","mstatus":"","insh":"0004164853003","cliId":"","pno":7067762757,"cno":7064994997,"email":"","ename":"","eno":"","pphy":"AMY WEEKS","ppno":7705328438,"pcpadd":"1240 JESSE JEWELL PKWY STE 200 STE 200","pcpcity":"WESTSIDE","pcpstate":"GA","pcpzip":305013861,"pcpcounty":"","pcpid":"","pcpname":"1240 JESSE JEWELL PKWY STE 200 STE 200","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"989 Wilson Rd","madd2":"","madd3":"","mcity":"Mount Airy","mstate":"GA","mzip":30563,"pcpfaxno":"","pcpnpi":1225771595,"currentgendcomment":"","pphycomment":"","uniqueid":435187,"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":["S32.030","S22.030","S36.119","S36.039","I62.9","Z11.3","R21","R30.0","J45.909","K66.1","S36.032","K68.3","S06.5XA","S27.322","I82.B12","S32.039","S32.049","S22.32X","J45.990","E87.20","D62","S36.222","S37.032","S00.11X","S30.1XX","R73.9","R33.9","Z53.29","Z83.3","Z84.1","Z84.0","Z82.49","Z00.00","R10.11","M79.18","R29.898","R41.841","R41.840","H53.8","R26.81","R26.89","R27.8","S06.5X1","Q04.8","M54.2","R51.9","R00.0","Z79.01","Z87.81","S06.9X1","M62.81","R13.19","G95.9","R53.1","I47.10","Z68.51","S37.012","V87.7XX","R50.9","V45.9XX","Z75.8","H54.7","S22.020","S36.229","N39.0","Z68.52","M54.16","J02.9","I82.90","R33.8","N30.00","D64.9","S22.000","S27.329","S32.009","M54.12","R82.90","L65.9","G90.A","S14.3XX","N48.89","R35.0","J84.10","D72.829","A41.9","N32.89","I62.00","G44.329","S06.9X9","H81.90","R42","G31.89","N31.9","K59.00","H53.9","F09","K59.2","S06.9XA","M62.838","R29.3","S06.34A","R18.8","S06.5X0","S29.9XX","S39.91X","S39.93X","S19.9XX","G43.009","R20.2","M51.36","I95.1","J01.90","M47.892","I47.19","I82.622","Q10.0","H26.101","Z13.31","Z68.24","Z23","I49.3","R41.89","S06.6XA","R26.2"],"date":["2024-07-30","2024-07-30","2024-08-15","2024-09-19","2025-04-17","2026-03-13","2026-03-13","2026-03-13","2024-10-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2025-04-17","2024-08-14","2024-08-14","2025-01-22","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-29","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2024-08-14","2025-12-18","2024-09-19","2024-12-23","2025-04-28","2024-12-23","2024-12-23","2024-12-23","2024-12-23","2025-01-30","2024-12-23","2024-11-25","2024-10-23","2025-04-28","2025-04-17","2024-10-23","2024-10-23","2024-10-23","2025-07-14","2025-03-31","2024-08-29","2024-10-22","2024-10-22","2024-12-10","2024-12-20","2024-08-15","2024-07-31","2024-08-13","2024-10-08","2024-08-21","2024-10-01","2024-10-28","2024-08-15","2024-09-11","2025-04-17","2024-12-11","2025-09-03","2025-01-17","2025-04-17","2024-12-17","2024-08-22","2024-12-06","2024-08-15","2024-12-06","2025-07-14","2024-12-10","2024-12-10","2025-07-17","2025-04-17","2024-11-09","2024-11-09","2024-08-10","2024-08-12","2024-08-10","2024-08-10","2024-08-10","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-01-13","2025-04-28","2025-04-28","2024-08-14","2024-08-12","2024-07-31","2024-07-31","2024-07-31","2024-07-31","2024-07-31","2025-07-14","2024-08-22","2024-08-22","2024-12-10","2025-11-12","2024-10-23","2024-11-13","2024-08-15","2025-02-10","2025-02-10","2025-12-18","2025-12-18","2025-12-18","2024-11-12","2025-01-13","2025-01-13","2024-08-09"],"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":[["","","Acetaminophen","325 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","10 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Dabigatran Etexilate","150 MG","","Select","Select",""],["","","Metoprolol Tartrate","25 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Promethazine Dm","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Pregabalin","50 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Midodrine Hcl","2.5 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Montelukast","10 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":""}]}]}