{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Angela Michelle Arthur","gend":1,"currentgend":"","add":"1204 Old Rockmart Rd SE","city":"Silver Creek","state":"GA","zip":30173,"dob":"1970-01-19","age":"","mstatus":"","insh":"0004906586001","cliId":"","pno":6156684137,"cno":6156684137,"email":"angiearthur22@gmail.com","ename":"","eno":"","pphy":"Daniel Grant","ppno":7622352180,"pcpadd":"101 REDMOND RD NW","pcpcity":"ROME","pcpstate":"GA","pcpzip":30165,"pcpcounty":"","pcpid":"","pcpname":"101 REDMOND RD NW","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1204 Old Rockmart Rd SE","madd2":"","madd3":"","mcity":"Silver Creek","mstate":"GA","mzip":30173,"pcpfaxno":7062388084,"pcpnpi":1114377207,"currentgendcomment":"","pphycomment":"","uniqueid":376939,"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":["G47.33","R06.89","N18.31","M32.9","S82.892","J20.9","K12.0","D49.2","M20.42","Z51.89","S82.852","Z79.899","M35.05","D31.31","Z13.5","H25.13","S93.432","I20.0","R06.02","E78.5","D64.9","M32.14","Z79.82","Z12.31","D89.89","M54.50","E66.9","G90.1","E78.2","E78.1","R05.9","Z20.822","R80.0","E78.00","R80.9","N18.32","R53.83","M54.16","M51.362","M81.0","Z98.1","M46.1","M25.551","Z68.41","M25.552","M25.571","K80.20","R06.09","I50.32","I10","I77.810","G90.9","N18.30","G40.909","I12.9","Z79.52","Z82.49","R11.0","K21.9","B37.2","F34.1","F51.5","I13.0","E66.01","M35.00","F32.A","S06.0X0","M79.7","Z90.49","Z91.199","F41.9","G43.909","G47.30","G89.29","I50.30","D63.1","R30.0","Z11.51","Z01.419","R87.810","R87.610","R07.2","Z12.11","Z83.719","D12.3","R13.19","S06.0X9","R56.9","M32.8","R07.89","E87.6","G43.719","M79.89","S82.51X","S82.831","M79.672","I50.9","F33.2","K12.1","I73.00","R53.1","Z74.09","Z98.890","Z04.3","G43.709","R55","R53.82","K59.00","G47.09","R00.2","G43.711","R94.31","R92.333","M25.572","M67.472","R73.9","M79.604","G89.4","R13.10","R54","Z91.81","Z68.38","S79.912","N32.81","G47.19","R07.9","S99.912","R87.620","R51.9","G90.A","J06.9","G44.52","M47.812","J30.2","M54.2","Z68.39","R10.9","N39.0","Z01.89","K82.8","Z12.39","Z12.4","L30.4","D48.5","L57.0","L81.4","L82.1","D22.39","D22.4","D22.5","D22.61","D22.62","D22.71","D22.72","I45.10","I35.1","R10.11","M48.061","Z01.818","Q79.62","G90.09","I95.1","N39.3","R06.01","R13.14","R35.1","R61","N20.0","M35.07","R07.1","S82.52X","S82.832","W10.8XX","M47.816","Z76.0","L29.9","M67.479","Z12.83","M25.559"],"date":["2026-03-12","2025-02-28","2025-09-02","2026-01-27","2025-03-01","2025-03-01","2025-02-28","2024-10-11","2024-10-11","2025-02-28","2025-09-18","2025-11-04","2025-11-04","2025-11-04","2024-03-11","2025-11-04","2025-02-17","2024-04-22","2024-04-22","2025-02-15","2025-02-15","2023-08-28","2025-02-15","2025-10-27","2024-04-24","2026-01-15","2025-09-18","2026-01-15","2025-11-24","2025-09-18","2025-02-24","2025-02-24","2023-08-24","2023-08-24","2025-10-23","2026-01-15","2026-01-27","2026-03-03","2026-03-03","2026-03-03","2026-03-05","2026-03-03","2026-03-03","2026-03-03","2026-03-03","2025-03-20","2024-09-18","2024-07-02","2025-11-24","2025-10-03","2025-12-10","2025-11-24","2025-12-26","2025-02-25","2025-12-26","2025-02-15","2024-04-18","2024-12-16","2025-02-16","2023-11-15","2024-12-16","2023-11-15","2025-11-24","2025-02-15","2026-01-27","2025-02-15","2025-02-20","2026-01-27","2025-02-15","2025-02-15","2025-02-15","2026-03-13","2025-02-15","2025-02-15","2025-05-20","2025-05-20","2024-12-12","2024-09-12","2024-09-12","2024-09-12","2024-09-12","2023-08-28","2024-11-06","2024-11-06","2024-11-06","2024-11-06","2025-02-19","2026-03-13","2025-02-25","2025-11-24","2024-12-16","2023-02-08","2025-02-25","2025-02-17","2025-02-17","2025-08-26","2025-02-17","2024-11-30","2026-01-27","2026-01-27","2025-08-11","2025-08-11","2025-08-11","2025-02-16","2026-03-13","2025-12-26","2025-12-26","2025-12-26","2025-12-26","2023-08-28","2023-05-17","2024-04-18","2025-10-27","2025-08-11","2024-09-18","2026-01-15","2026-02-06","2024-09-09","2024-11-06","2024-09-09","2024-09-09","2024-09-09","2025-02-19","2024-10-15","2024-10-16","2024-04-18","2025-02-15","2024-10-15","2025-02-03","2025-11-24","2025-01-13","2025-07-23","2024-05-22","2024-06-28","2024-09-27","2024-07-11","2024-12-26","2024-11-14","2023-03-24","2024-07-15","2023-04-17","2023-04-17","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2024-09-16","2023-08-28","2024-04-19","2024-06-28","2025-09-18","2024-09-09","2024-11-13","2024-11-13","2024-11-13","2024-08-01","2024-08-01","2024-08-01","2024-08-01","2024-08-01","2024-12-26","2024-05-01","2024-05-01","2025-02-16","2025-02-16","2025-02-20","2026-02-06","2024-12-16","2024-12-16","2024-06-28","2024-06-28","2024-06-28"],"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":[["","","Simvastatin","20 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","300 MG","","Select","Select",""],["","","Hydroxychloroquine Sulfate","200 MG","","Select","Select",""],["","","Fluticasone Propionate","","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Desmopressin Acetate","0.1 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","Lacosamide","200 MG","","Select","Select",""],["","","Emgality","120 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","5 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Tizanidine","4 MG","","Select","Select",""],["","","Metoprolol Tartrate","50 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Colchicine","0.6 MG","","Select","Select",""],["","","Modafinil","200 MG","","Select","Select",""],["","","Prochlorperazine Maleate","","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Potassium Chloride","10 MEQ","","Select","Select",""],["","","Hydroxyzine Hydrochloride","25 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","1.5 Ml Fremanezumab-Vfrm","150 MG","","Select","Select",""],["","","Restasis","","","Select","Select",""],["","","Fenofibrate","48 MG","","Select","Select",""],["","","Ubrelvy","100 MG","","Select","Select",""],["","","Desonide","0.5 MG","","Select","Select",""],["","","Amphetamine\/Dextroamphetamine","","","Select","Select",""],["","","Midodrine Hcl","5 MG","","Select","Select",""],["","","Clonidine Hydrochloride","0.1 MG","","Select","Select",""],["","","Fludrocortisone","0.1 MG","","Select","Select",""],["","","Topiramate","100 MG","","Select","Select",""],["","","Fludrocortisone Acetate","0.1 MG","","Select","Select",""],["","","Midodrine Hydrochloride","5 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","10 MEQ","","Select","Select",""],["","","Pantoprazole Sod Dr","40 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","100 MG","","Select","Select",""],["","","Qulipta","60 MG","","Select","Select",""],["","","Desonide 0.05% Cream","","","Select","Select",""],["","","Prochlorperazine","10 MG","","Select","Select",""],["","","Aspirin Ec","81 MG","","Select","Select",""],["","","Potassium Cl Er","10 MEQ","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Potassium Chloride Er","","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Trazodone Hydrochloride","50 MG","","Select","Select",""],["","","Propranolol Hydrochloride Er","","","Select","Select",""],["","","Polyethylene Glycol 3350","236000 MG","","Select","Select",""],["","","Promethazine Hydrochloride","25 MG","","Select","Select",""],["","","Pyridostigmine Bromide","60 MG","","Select","Select",""],["","","Guanfacine","1 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":""}]}]}