{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jimmy R Allen","gend":0,"currentgend":"","add":"104 Telico Dr","city":"Dalton","state":"GA","zip":"30721","dob":"1964-03-27","age":"","mstatus":"","insh":"0004429123001","cliId":"","pno":"7069345005","cno":"7069345005","email":"readywhenurcb@yahoo.com","ename":"","eno":"","pphy":"Chirag Patel","ppno":"4234684826","pcpadd":"7425 ZIEGLER RD STE 143","pcpcity":"CHATTANOOGA","pcpstate":"TN","pcpzip":"37421","pcpcounty":"","pcpid":"","pcpname":"7425 ZIEGLER RD STE 143","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"104 Telico Dr","madd2":"","madd3":"","mcity":"Dalton","mstate":"GA","mzip":"30721","pcpfaxno":"4234684799","pcpnpi":"1790741312","currentgendcomment":"","pphycomment":"","uniqueid":"321258","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":["E11.65","I10","E78.49","G47.33","K76.0","I23.1","R94.31","I44.4","I49.1","I27.89","R07.89","R42","E11.9","R06.02","M51.369","I25.10","R29.6","Z96.652","Z82.49","Z83.3","Z79.84","Z20.822","I51.7","I36.1","I34.1","K75.81","F41.1","R05.1","B34.9","R11.0","E11.42","M79.18","R30.0","N30.01","K74.60","K76.6","R16.2","R94.5","I25.89","I50.33","R00.2","I25.9","G89.29","Z79.891","R19.7","E78.5","K74.02","M47.816","M25.561","M25.531","M79.2","M54.59","S39.92X","W19.XXX","M54.50","R07.9","E78.00","Z87.891"],"date":["2026-06-12","2026-08-11","2026-06-12","2026-08-11","2026-05-29","2026-03-07","2026-03-07","2026-03-07","2026-03-07","2026-03-07","2026-03-06","2026-03-07","2026-08-11","2026-03-07","2026-03-07","2026-08-04","2026-03-07","2026-07-27","2026-03-07","2026-03-07","2026-08-11","2026-03-07","2026-08-05","2026-08-05","2026-08-05","2026-08-11","2026-02-14","2026-02-13","2026-02-13","2026-02-13","2026-02-13","2026-02-13","2026-08-05","2026-08-05","2026-08-11","2026-08-11","2026-08-11","2026-08-11","2026-07-15","2026-07-15","2026-07-15","2026-08-03","2026-08-10","2026-07-27","2026-07-27","2026-07-27","2026-05-29","2026-08-10","2026-08-10","2026-04-29","2026-08-10","2026-08-10","2026-05-19","2026-05-19","2026-07-27","2026-03-06","2026-08-11","2026-08-11"],"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":[["","","VENLAFAXINE HYDROCHLORIDE ER","37500 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","20000 MG","","Select","Select",""],["","","FARXIGA","10000 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50000 MCG\/ACT","","Select","Select",""],["","","MONTELUKAST SODIUM","10000 MG","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","1000000 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","PIOGLITAZONE HYDROCHLORIDE","30000 MG","","Select","Select",""],["","","GLIMEPIRIDE","2000 MG","","Select","Select",""],["","","RYBELSUS","7000 MG","","Select","Select",""],["","","LISINOPRIL\/HYDROCHLOROTHIAZIDE","0","","Select","Select",""],["","","TAMSULOSIN HYDROCHLORIDE","400 MG","","Select","Select",""],["","","ONDANSETRON ODT","4000 MG","","Select","Select",""],["","","METOPROLOL TARTRATE","50000 MG","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","120 %","","Select","Select",""],["","","AMOXICILLIN","875000 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":""}]}]}