{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karen Amundsen","gend":1,"currentgend":"","add":"107 Ashwood Ct","city":"Leesburg","state":"GA","zip":31763,"dob":"1965-05-19","age":"","mstatus":"","insh":"0004666041001","cliId":"","pno":2296690128,"cno":2296690128,"email":"karenamatoamundsen@gmail.com","ename":"","eno":"","pphy":"Charles Kemp","ppno":2294383302,"pcpadd":"2402 OSLER CT","pcpcity":"ALBANY","pcpstate":"GA","pcpzip":31707,"pcpcounty":"","pcpid":"","pcpname":"2402 OSLER CT","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"107 Ashwood Ct","madd2":"","madd3":"","mcity":"Leesburg","mstate":"GA","mzip":31763,"pcpfaxno":2294383384,"pcpnpi":1093035784,"currentgendcomment":"","pphycomment":"","uniqueid":326738,"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":["R50.9","R05.1","I10","J43.9","F17.210","J44.9","M25.562","S83.272","H61.23","E66.9","Z00.00","E04.1","E78.2","E55.9","R73.09","S83.282","S83.402","R29.898","Z13.31","R26.89","Z01.411","Z12.11","N95.0","K64.9","Z79.890","F51.04","M54.50","M54.16","R20.2","M79.606","R91.1","I70.0","I25.10","Z90.49","F32.9","R91.8","Z01.810","Z01.419","M25.471","M62.81","G57.11","M25.551","F32.1","Z87.891","E66.3","Q68.6","M23.252","M23.242","M94.8X8","M25.462","M65.962","I31.39","M47.814","G62.9","Z12.31","D25.1","S83.412","M71.22"],"date":["2025-03-05","2025-03-05","2026-02-04","2026-02-04","2026-03-05","2025-10-02","2026-03-11","2025-12-19","2025-06-03","2025-06-03","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2025-12-19","2025-09-10","2025-09-10","2026-02-04","2026-03-11","2024-12-18","2024-12-18","2025-01-06","2024-12-18","2025-01-06","2024-12-18","2025-04-14","2025-04-14","2025-04-15","2025-04-15","2026-03-05","2025-03-04","2025-03-04","2025-03-04","2024-12-11","2026-02-04","2025-12-10","2024-12-18","2025-08-19","2025-10-27","2025-04-15","2025-04-15","2026-02-04","2026-02-04","2026-02-04","2025-09-18","2025-10-02","2025-10-02","2025-09-10","2025-11-18","2025-09-10","2026-03-05","2025-03-04","2025-03-25","2024-12-18","2025-01-06","2025-11-18","2025-11-18"],"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":[["","","Medroxyprogesterone","2.5 MG","","Select","Select",""],["","","Estradiol","2 MG","","Select","Select",""],["","","Hydrocortisone","25 MG","","Select","Select",""],["","","Zolpidem Tartrate","10 MG","","Select","Select",""],["","","Ergocalciferol","1.25 MG","","Select","Select",""],["","","Albuterol Sul","2.5 MG","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Medroxyprogesterone Acetate","","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Nabumetone","500 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Ibuprofen","","","Select","Select",""],["","","Hydrocodone\/Acetaminophen","","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Sertraline","100 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 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":""}]}]}