{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lori Mcelrath","gend":1,"currentgend":"","add":"119 Chastain Dr NE","city":"Calhoun","state":"GA","zip":30701,"dob":"1967-02-13","age":"","mstatus":"","insh":"0004782811001","cliId":"","pno":7068798269,"cno":7068798269,"email":"lorilmcelrath1215@gmail.com","ename":"","eno":"","pphy":"Pablo Balboa-Marciack","ppno":7066028200,"pcpadd":"100 HOSPITAL CT","pcpcity":"CALHOUN","pcpstate":"GA","pcpzip":30701,"pcpcounty":"","pcpid":"","pcpname":"100 HOSPITAL CT","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"119 Chastain Dr NE","madd2":"","madd3":"","mcity":"Calhoun","mstate":"GA","mzip":30701,"pcpfaxno":7066021354,"pcpnpi":1255357067,"currentgendcomment":"","pphycomment":"","uniqueid":258886,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F06.34","F31.81","Z79.899","M79.604","R30.0","N30.00","I10","Z87.442","Z86.59","Z87.891","Z88.2","M51.16","M51.372","M47.819","T81.31X","M47.816","M51.362","M54.16","L02.415","F31.9","G89.29","Z96.651","F43.10","M54.9","Z79.82","Z86.19","Z87.440","Z81.8","Z82.49","Z01.818","Z03.89","M54.41","M17.11","M25.561","D64.9","N30.01","T84.54X","F43.12","R53.82","T84.53X","R68.89","J01.90","R05.1","R09.82","B37.9","T36.95X","J02.9","J02.0","S86.911","M54.31","M79.661","E66.9","R00.0","M51.26","M00.861","N39.0","D72.829","R06.02","E66.09","Z68.30","R74.8","R70.0","N18.9","R79.82","R35.0","Z68.35","Z79.2","R20.2","M47.896","M54.50","R29.898","E66.812","Z68.36","A08.39","M54.59","T84.50X","R60.0","M22.41","M84.451","S86.891","M96.840","Z47.1","R26.89","R53.81","G89.18"],"date":["2024-02-09","2026-01-23","2025-11-13","2024-06-24","2026-01-17","2025-08-08","2026-01-23","2024-09-03","2024-09-03","2024-11-06","2024-10-15","2025-05-05","2025-05-05","2025-05-05","2025-01-22","2024-11-05","2024-11-01","2024-11-01","2024-12-20","2024-11-06","2024-11-06","2025-03-24","2024-11-06","2024-11-06","2024-11-06","2024-11-06","2024-11-06","2024-11-06","2024-11-06","2025-04-25","2024-08-29","2025-07-23","2025-07-23","2024-12-18","2024-11-18","2026-01-17","2024-12-14","2026-01-23","2025-12-19","2024-12-20","2025-09-16","2025-09-16","2026-01-17","2025-09-16","2025-09-16","2025-09-16","2026-01-17","2026-01-17","2025-01-31","2025-03-24","2024-06-25","2026-01-23","2024-11-05","2025-05-05","2024-11-08","2024-12-02","2024-11-08","2025-09-16","2024-10-29","2024-02-23","2024-12-16","2024-12-16","2024-12-16","2024-12-16","2024-02-09","2024-02-09","2024-12-02","2025-05-05","2025-05-05","2025-04-22","2025-04-22","2024-10-29","2024-10-29","2026-03-18","2024-10-24","2024-12-18","2024-12-18","2024-07-30","2024-07-30","2024-06-07","2024-10-15","2024-09-03","2024-09-03","2024-09-03","2024-11-06"],"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":[["","","24 Hr Oxybutynin Chloride","10 MG","","Select","Select",""],["","","24 Hr Desvenlafaxine Succinate","100 MG","","Select","Select",""],["","","Oxycodone-Acetaminophen 5-325","","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Methocarbamol","750 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Desvenlafaxine Er","","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Hydroxyzine Pamoate","","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Propranolol Hydrochloride","10 MG","","Select","Select",""],["","","Quetiapine","300 MG","","Select","Select",""],["","","24 Hr Divalproex Sodium","250 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Lumateperone","42 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Nda021457 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Dicyclomine Hydrochloride","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":""}]}]}