{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Savannah Cabral","gend":1,"currentgend":"","add":"5131 Arthur Ct","city":"Oakwood","state":"GA","zip":30566,"dob":"1992-06-10","age":"","mstatus":"","insh":"0004625981001","cliId":"","pno":6783162499,"cno":6786170884,"email":"savannahlcabral@gmail.com","ename":"","eno":"","pphy":"Monica Newton","ppno":6784508969,"pcpadd":"1439 JESSE JEWELL PKWY NE STE 102","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":30501,"pcpcounty":"","pcpid":"","pcpname":"1439 JESSE JEWELL PKWY NE STE 102","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"5131 Arthur Ct","madd2":"","madd3":"","mcity":"Oakwood","mstate":"GA","mzip":30566,"pcpfaxno":6784508957,"pcpnpi":1285606707,"currentgendcomment":"","pphycomment":"","uniqueid":294080,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z11.3","N89.8","L91.8","B96.89","Z01.89","Z32.02","Z30.433","F43.23","Z30.431","Z68.26","R53.83","Z63.0","R11.0","M54.50","M25.551","M53.3","M99.06","M99.03","M99.04","G89.29","M25.552","Z68.25","M54.9","L29.9","R22.0","Z87.42","M54.59","R10.2","M99.05","M54.41","H01.02A","H01.02B","H04.123","H43.812","H52.7","Z20.2","R35.0","E03.9","R20.2","Z13.0","Z13.1","Z13.220","Z00.00","F17.290","J02.0","Z20.822","R50.9","Z68.24","N76.0","R51.9","R00.2","M47.814","Z76.89","Z85.6","R06.02","R05.1","F41.9","Z30.09","Z97.5","M21.41","M25.861","M21.42","T67.01X","M25.561","M22.2X1","M62.81","R26.89","Z12.4","M51.27","M51.370"],"date":["2025-12-22","2025-12-22","2025-12-22","2025-12-22","2025-09-16","2024-01-22","2024-01-22","2025-10-07","2025-05-13","2025-09-16","2025-09-16","2025-10-07","2024-02-26","2024-10-25","2024-08-20","2024-10-08","2024-08-20","2024-08-20","2024-08-20","2024-10-25","2024-08-20","2025-12-30","2024-10-15","2026-01-01","2026-01-01","2024-09-18","2024-10-25","2024-07-02","2024-07-02","2024-10-07","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2023-02-09","2026-01-01","2024-01-15","2025-06-03","2025-06-03","2025-06-03","2025-06-03","2025-06-03","2024-10-25","2024-10-08","2023-07-23","2023-07-23","2023-07-23","2024-06-07","2025-12-22","2024-02-26","2023-08-08","2024-10-15","2023-01-23","2024-01-15","2024-10-25","2025-12-30","2024-09-20","2024-01-15","2024-01-29","2024-08-20","2024-08-20","2024-08-20","2023-08-08","2023-10-26","2023-10-26","2023-10-26","2023-10-26","2024-09-18","2024-10-14","2024-10-14"],"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":[["","","Amoxicillin","875 MG","","Select","Select",""],["","","Promethazine Hydrochloride","12.5 MG","","Select","Select",""],["","","Meloxicam","7.5 MG","","Select","Select",""],["","","Buspirone Hydrochloride","5 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Valacyclovir","500 MG","","Select","Select",""],["","","Cyclobenzaprine","10 MG","","Select","Select",""],["","","Triamcinolone 0.1% Ointment","","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Hydroxyzine Hydrochloride","25 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 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":""}]}]}