{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jamie Cheryl Collins","gend":1,"currentgend":"","add":"3772 E Hall Rd","city":"Gainesville","state":"GA","zip":30507,"dob":"1965-12-20","age":"","mstatus":"","insh":"0004193734002","cliId":"","pno":6786177735,"cno":6786177735,"email":"david.collins1968@yahoo.com","ename":"","eno":"","pphy":"Dimpu Patel","ppno":6784500202,"pcpadd":"743 SPRING ST NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013715,"pcpcounty":"","pcpid":"","pcpname":"743 SPRING ST NE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"3772 E Hall Rd","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30507,"pcpfaxno":"","pcpnpi":1992001523,"currentgendcomment":"","pphycomment":"","uniqueid":341727,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N17.9","I95.9","E83.51","E87.20","D64.9","E83.39","N39.0","A49.9","K57.90","E83.52","M25.519","I10","F17.210","N20.0","R03.0","Z68.23","A41.9","R65.21","G92.8","J18.9","J96.01","N17.0","Z20.822","A04.72","F10.239","K86.1","N30.00","Z16.12","K70.10","D63.8","E87.6","E87.70","K70.30","B96.20","K76.82","T38.0X5","M10.9","R50.9","K25.3","R10.13","K63.5","D12.5","K57.30","K64.8","F10.11","I12.9","N18.9","L81.4","L82.1","D48.5","Z85.828","L57.0","E87.21","R80.9","D63.1","N28.9","N18.2","E83.30","R60.0","K74.60","D72.829","K76.0","C44.622","D04.61","N18.31","E83.9","N18.32","Z46.82","K59.89","R91.8","Z45.2","J81.1","J98.4","J98.11","N32.89","C44.529","L90.5","M79.89","N28.86","T19.1XX","T19.0XX","Z46.6","R79.89","R31.29","D53.9","E43","L81.8","D04.5","C44.519","N30.01","E87.29","Z78.9","F10.10","Z13.6","Z13.0","Z13.220","Z13.29","E55.9","K25.9","F41.0","Z23","F10.20","R73.01","Z68.25","Z12.11","K29.50","K21.00","Z12.12","R42","C44.722","H25.13","C44.521","L01.00","Z68.22","Z01.419","Z09","G93.40","J90","A49.8","K29.70","K70.9","K86.0","G47.61","M10.371","Z68.24","J18.1","R82.991","R06.02","L85.3","K29.60","C44.619","D04.71","M79.10","L29.9","G47.00","Z68.26","R10.84","Z00.00","Z12.31","I13.10","I82.612","D72.9","R21","R74.8","R53.83","R10.11","Z68.27","N20.1","N21.0","Z68.28"],"date":["2025-06-26","2023-07-23","2023-07-28","2023-12-22","2023-09-27","2023-07-28","2024-08-22","2023-09-06","2023-09-06","2023-11-06","2023-09-06","2025-08-08","2025-09-11","2025-09-11","2024-04-01","2024-04-01","2023-07-31","2023-07-31","2023-07-09","2023-07-06","2023-07-28","2023-06-29","2023-06-29","2023-07-14","2023-06-29","2023-06-30","2023-06-30","2023-07-09","2023-06-29","2023-06-29","2023-12-22","2023-07-31","2025-03-26","2023-06-29","2023-06-29","2023-06-29","2024-10-24","2024-01-02","2024-01-15","2024-01-15","2024-01-15","2024-01-15","2024-01-15","2024-01-15","2025-03-19","2024-01-15","2025-08-08","2026-02-25","2025-10-20","2026-02-25","2026-02-25","2026-02-25","2023-07-02","2023-11-06","2023-11-06","2023-11-06","2023-11-06","2023-07-30","2023-08-03","2025-08-11","2023-12-22","2025-09-10","2026-02-25","2025-06-16","2025-08-08","2025-08-08","2025-09-11","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-06","2023-07-15","2023-07-06","2023-07-11","2025-10-20","2024-02-07","2023-07-04","2024-02-21","2024-07-25","2024-07-25","2024-07-25","2024-09-04","2024-02-08","2023-08-03","2023-08-03","2026-02-25","2024-09-11","2026-02-25","2024-01-02","2023-07-20","2023-07-07","2023-06-30","2024-06-24","2024-06-24","2024-06-24","2024-06-24","2023-09-25","2025-05-12","2025-01-02","2024-07-02","2024-07-02","2025-07-02","2025-07-02","2024-01-15","2024-01-15","2024-01-15","2023-10-02","2023-07-12","2026-02-25","2026-03-19","2025-10-20","2025-02-05","2023-11-22","2025-07-02","2023-08-24","2023-07-09","2023-09-06","2023-07-09","2024-09-04","2024-03-28","2023-07-07","2025-03-27","2024-03-28","2024-03-28","2023-07-25","2025-09-11","2023-06-30","2024-09-11","2024-01-15","2023-12-20","2023-12-20","2023-08-03","2023-09-12","2025-07-02","2023-08-03","2023-09-06","2025-07-02","2025-07-02","2025-07-02","2023-07-25","2023-07-29","2023-07-29","2023-07-07","2023-06-29","2023-09-12","2025-01-02","2024-04-17","2024-04-17","2024-10-24"],"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":[["","","Gabapentin","300 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Trazodone Hydrochloride","","","Select","Select",""],["","","Allopurinol","100 MG","","Select","Select",""],["","","Midodrine Hydrochloride","5 MG","","Select","Select",""],["","","Folic Acid","1 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Nitrofurantoin, Macrocrystals","25 MG","","Select","Select",""],["","","Imiquimod","50 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 Mg","","","Select","Select",""],["","","Sevelamer Carbonate","800 MG","","Select","Select",""],["","","Hydroxyzine Pamoate","50 MG","","Select","Select",""],["","","Midodrine Hcl","5 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Cefuroxime","500 MG","","Select","Select",""],["","","Fluorouracil","50 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Colchicine","0.6 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":""}]}]}