{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Betty Jean Atkins","gend":1,"currentgend":"","add":"705 Wilson Rd","city":"Cedartown","state":"GA","zip":30125,"dob":"1961-05-17","age":"","mstatus":"","insh":"0004636043001","cliId":"","pno":7703243517,"cno":7703243517,"email":"none@aol.com","ename":"","eno":"","pphy":"CAROLYN FALK-TRAN","ppno":7062910291,"pcpadd":"501 REDMOND RD NW","pcpcity":"ROME","pcpstate":"GA","pcpzip":30165,"pcpcounty":"","pcpid":"","pcpname":"501 REDMOND RD NW","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"705 Wilson Rd","madd2":"","madd3":"","mcity":"Cedartown","mstate":"GA","mzip":30125,"pcpfaxno":"","pcpnpi":1144726860,"currentgendcomment":"","pphycomment":"","uniqueid":291892,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z00.00","E89.0","E78.2","I10","D50.8","R53.83","R06.09","F32.0","R73.01","R91.1","R49.0","K21.9","G56.21","I25.10","Z79.890","Z79.82","Z79.899","Z79.02","Z88.2","Z88.5","D64.9","I34.0","R13.12","J38.01","J31.0","Z23","G56.01","M65.351","M65.341","Z00.01","H10.13","M54.51","M48.061","M62.830","M25.541","M25.542","M25.561","M25.562","M25.571","M25.572","M25.521","M25.522","L65.9","R06.00","I20.89","Z95.5","D62","I27.21","E03.9","E05.90","F32.A","D50.9","I25.119","I95.9","E78.5","F41.9","G43.909","I73.00","Z90.710","Z90.49","Z90.721","L57.8","D22.5","L82.1","L81.4","L82.0","L53.8","L29.89","D89.89","Z12.31","M79.644","G56.23","I20.0","M77.12","J44.9","K68.3","M25.512","J30.9","Z68.21","Z01.818","Z45.2","S30.1XX","G43.009","R09.89","R13.11","M65.831","W18.39X","I25.118","Z98.890","I95.1","R58","R76.0","J45.40","R59.0","F17.201","R06.02","M54.16","M54.59","M46.1","Z96.82","G89.4","I30.9","M79.604","Z09","R05.1","J01.00","H66.002","Z03.89","K66.1"],"date":["2024-06-17","2025-12-23","2025-12-23","2025-12-23","2026-01-19","2025-12-23","2025-11-11","2025-12-23","2025-12-23","2025-12-23","2024-12-19","2025-02-20","2023-09-08","2025-11-11","2025-11-11","2025-11-11","2025-11-11","2025-11-11","2025-11-11","2025-11-11","2026-01-29","2025-03-12","2023-06-26","2023-07-26","2025-12-23","2025-02-20","2023-11-16","2023-11-16","2023-11-16","2025-06-24","2025-06-24","2025-12-23","2025-12-23","2025-12-23","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2023-03-22","2025-07-28","2025-12-22","2025-11-10","2025-02-07","2025-02-07","2025-02-09","2025-02-07","2025-02-09","2025-02-07","2025-02-07","2025-02-09","2025-02-09","2025-02-20","2025-02-09","2025-02-07","2025-02-07","2025-02-07","2025-02-07","2025-09-03","2025-09-03","2025-09-03","2025-09-03","2025-09-03","2025-09-03","2025-09-03","2023-12-11","2024-12-26","2023-09-08","2023-10-04","2024-12-20","2023-02-03","2025-03-20","2025-02-20","2023-09-08","2023-08-15","2025-05-20","2025-11-10","2025-11-10","2025-02-07","2025-02-20","2023-04-25","2023-04-25","2023-10-12","2025-05-20","2025-12-26","2025-11-11","2025-02-07","2025-02-07","2023-12-11","2025-06-17","2025-06-17","2025-06-17","2025-03-12","2025-07-16","2025-07-16","2025-07-16","2025-07-16","2025-07-16","2025-12-26","2025-02-07","2025-02-07","2024-01-01","2024-01-01","2024-01-01","2025-02-07","2025-02-08"],"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":[["","","Pravastatin Sodium","40 MG","","Select","Select",""],["","","Topiramate","50 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","50 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.088 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","Famotidine","20 MG","","Select","Select",""],["","","Omeprazole Dr","40 MG","","Select","Select",""],["","","12 Hr Orphenadrine Citrate","100 MG","","Select","Select",""],["","","Airsupra","","","Select","Select",""],["","","Polymyxin B 10000 Unt\/Ml \/ Trimethoprim","1 MG","","Select","Select",""],["","","24 Hr Isosorbide Mononitrate","30 MG","","Select","Select",""],["","","Aspirin","81 MG","","Select","Select",""],["","","Clopidogrel","75 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Ketorolac Tromethamine","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":""}]}]}