{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tammy L Vaca","gend":1,"currentgend":"","add":"3235 Hilltop Cir","city":"Gainesville","state":"GA","zip":30506,"dob":"1969-05-08","age":"","mstatus":"","insh":"0004750873001","cliId":"","pno":3214434380,"cno":3214434380,"email":"tamvaca69@yahoo.com","ename":"","eno":"","pphy":"Abhishek Singh","ppno":7702199445,"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":"3235 Hilltop Cir","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30506,"pcpfaxno":"","pcpnpi":1851734099,"currentgendcomment":"","pphycomment":"","uniqueid":311542,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K74.60","E11.40","E05.90","Z68.26","M54.12","E87.1","E86.0","R19.7","I10","E11.9","E78.5","K21.9","F41.1","Z79.84","E78.1","Z13.0","Z00.01","Z23","Z68.29","Z68.31","M25.511","G89.29","M25.512","Z68.30","R53.82","R07.89","Z00.00","Z12.31","K52.9","K57.30","Z83.3","Z82.49","Z86.010","I85.00","N17.9","Z68.28","K74.69","Z90.49","R39.9","R42","Z68.27","R94.31","Z12.11","I85.10","R07.9","G44.209","K75.81","J06.9","K92.1","G57.92","Z68.25","E04.9","E87.6","Z01.419","Z11.4","R13.10","E66.01","E66.8","R10.11","Z20.822","R10.84","K76.0","I47.10","R19.07","L29.9","K76.82","D22.39","L81.4","Z71.89","D48.5","D23.39","D23.4","R16.1","C22.0","H00.022","H01.002","R51.9","E66.9","Z11.59","K76.9","R10.10","Z53.29","M50.122","M47.22","M43.12","G47.10","R06.83","R79.89","N28.1","K42.9","G47.19"],"date":["2026-02-19","2026-01-05","2026-02-23","2025-04-10","2025-12-01","2023-08-03","2023-08-03","2023-08-03","2026-01-19","2025-09-11","2024-05-02","2025-07-10","2024-09-11","2023-08-03","2025-09-11","2025-09-11","2025-09-11","2025-09-11","2025-09-11","2026-02-19","2023-09-25","2023-09-25","2023-09-25","2025-12-18","2026-02-19","2023-05-11","2024-09-11","2024-09-24","2024-05-02","2024-05-02","2024-05-02","2024-05-02","2024-05-02","2026-02-18","2023-08-07","2025-07-14","2024-11-18","2025-06-02","2023-04-20","2024-08-26","2025-08-30","2024-05-09","2024-05-02","2025-08-14","2025-08-30","2023-05-11","2024-11-18","2024-01-18","2025-03-19","2024-12-11","2025-03-19","2026-02-23","2024-06-10","2024-09-11","2023-06-19","2023-04-20","2025-03-19","2024-01-25","2026-01-19","2024-01-18","2025-08-30","2024-04-29","2024-04-19","2026-01-05","2026-01-05","2026-02-18","2023-01-23","2023-01-23","2023-01-23","2023-01-23","2023-01-23","2023-01-23","2024-11-30","2024-11-30","2023-01-19","2023-01-19","2025-12-18","2024-03-04","2024-09-11","2024-04-29","2025-11-18","2025-01-24","2025-09-11","2025-09-11","2025-09-11","2026-01-19","2023-01-30","2025-06-02","2024-04-29","2024-04-29","2026-01-19"],"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":[["","","Ozempic 0.25-0.5 Mg\/Dose Pen","","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","Escitalopram","20 MG","","Select","Select",""],["","","Ozempic","1 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","24 Hr Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Metoprolol Tartrate","100 MG","","Select","Select",""],["","","Nadolol","80 MG","","Select","Select",""],["","","Rifaximin","550 MG","","Select","Select",""],["","","Lisinopril","40 MG","","Select","Select",""],["","","Rosuvastatin Calcium","5 MG","","Select","Select",""],["","","Methimazole","5 MG","","Select","Select",""],["","","Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Furosemide","","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Pregabalin","75 MG","","Select","Select",""],["","","Fenofibrate","145 MG","","Select","Select",""],["","","Bacitracin 0.5 Unt\/Mg \/ Polymyxin B 10 Unt\/Mg Ophthalmic Ointment","","","Select","Select",""],["","","Modafinil","200 MG","","Select","Select",""],["","","Hydroxyzine Hydrochloride","25 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Dexcom G7 Receiver","","","Select","Select",""],["","","Magnesium Sulfate","225 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","1 Ml Hepatitis A Vaccine Inactivated Strain Hm175 720 Unt\/Ml \/ Hepatitis B Surface Antigen Vaccine","0.02 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":""}]}]}