{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carla Jean Shumaker","gend":1,"currentgend":"","add":"140 Duncan Mill Rd","city":"Blairsville","state":"GA","zip":30512,"dob":"1975-01-31","age":"","mstatus":"","insh":"0004192695001","cliId":"","pno":7069942998,"cno":7069942998,"email":"carlashumaker@me.com","ename":"","eno":"","pphy":"Robert Graham","ppno":4237525004,"pcpadd":"975 EAST THIRD STREET","pcpcity":"CHATTANOOGA","pcpstate":"TN","pcpzip":37403,"pcpcounty":"","pcpid":"","pcpname":"975 EAST THIRD STREET","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"140 Duncan Mill Rd","madd2":"","madd3":"","mcity":"Blairsville","mstate":"GA","mzip":30512,"pcpfaxno":4234143834,"pcpnpi":1306068135,"currentgendcomment":"","pphycomment":"","uniqueid":294097,"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":["C49.22","R60.0","R59.1","I10","Z79.899","C77.9","C78.01","D62","C78.02","Z91.81","F41.9","C76.52","C40.22","C78.00","C49.9","M79.605","S81.802","C49.20","Z01.810","I49.1","C77.2","Z98.890","E04.9","D17.20","R22.42","Z48.1","Z85.828","T86.821","Z85.831","G89.18"],"date":["2026-02-06","2026-02-06","2026-02-06","2026-02-06","2026-02-06","2025-12-10","2025-12-10","2025-12-10","2025-12-10","2025-12-10","2026-02-06","2025-10-02","2025-12-16","2025-12-16","2026-02-12","2026-02-12","2026-02-12","2025-10-06","2025-12-05","2025-12-05","2025-11-17","2025-11-17","2025-11-17","2025-10-01","2025-10-02","2025-12-16","2025-12-16","2026-02-06","2026-02-06","2025-12-10"],"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":[["","","Ondansetron","8 MG","","Select","Select",""],["","","Hydrochlorothiazide","25 MG","","Select","Select",""],["","","Sumatriptan","100 MG","","Select","Select",""],["","","Chlorhexidine 0.12% Rinse","","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","Spironolactone-Hctz 25-25 Tab","","","Select","Select",""],["","","Vitamin B12","1 MG","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Cyanocobalamin 1,000 Mcg\/Ml Vl","","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Fluticasone Propionate","0.05 MG","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Lidocaine Hydrochloride","20 MG","","Select","Select",""],["","","Cyanocobalamin","","","Select","Select",""],["","","Meloxicam","7.5 MG","","Select","Select",""],["","","Famotidine","","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","","","Select","Select",""],["","","Amox-Clav 875-125 Mg Tablet","","","Select","Select",""],["","","Anucort-Hc","25 MG","","Select","Select",""],["","","Hydrocortisone","10 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Pregabalin","75 MG","","Select","Select",""],["","","Hydromorphone Hcl","","","Select","Select",""],["","","0.4 Ml Enoxaparin Sodium","100 MG","","Select","Select",""],["","","Collagenase 0.25 Unt\/Mg Topical Ointment [Santyl]","","","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":""}]}]}