{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dejuan Martin","gend":1,"currentgend":"","add":"6600 Shoal Creek Rd","city":"Clermont","state":"GA","zip":30527,"dob":"1961-09-03","age":"","mstatus":"","insh":"0004951875001","cliId":"","pno":6787762220,"cno":6787769969,"email":"dejuan@kdmgroupllc.com","ename":"","eno":"","pphy":"Anna Powell","ppno":7068651234,"pcpadd":"4754 MARTIN RD","pcpcity":"FLOWERY BRANCH","pcpstate":"GA","pcpzip":30542,"pcpcounty":"","pcpid":"","pcpname":"4754 MARTIN RD","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"6600 Shoal Creek Rd","madd2":"","madd3":"","mcity":"Clermont","mstate":"GA","mzip":30527,"pcpfaxno":7068657265,"pcpnpi":1336377423,"currentgendcomment":"","pphycomment":"","uniqueid":349358,"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":["R00.2","E89.0","R10.9","K21.00","Z85.828","E78.2","Z98.890","Z90.49","F32.A","N18.31","Z85.850","Z79.890","Z79.899","Z87.891","Z79.82","Z96.652","M25.562","G89.18","M62.81","Z12.11","Z68.33","M47.816","M53.3","G89.29","Z79.891","Z51.81","F34.1","F11.20","N17.9","E86.0","K52.9","R65.10","R10.13","F40.231","M46.1","G47.33","A04.72","G89.4","M51.16","R53.83","N95.1","R68.82","H93.19","K63.89","K51.90","E03.8","Z82.49","Z83.3","R42","E78.00","R73.9","G47.30","Z12.31","R07.81","K21.9","Z68.35","E03.9","M17.12","Z47.1","R07.9","Z68.32","Z29.9","H93.12","H90.A21","Z00.00","Z68.34","F41.9","M54.12","E66.811","M50.320","M47.812","F32.89","M54.16","Q80.0","D22.5","D22.62","D22.61","D22.71","D22.72","D22.39","L82.1","L81.4","L56.8","L57.3","L81.8","M19.041","M51.36","M79.671","M77.31","C73","M46.07","R63.5","Z01.411","R51.9","Z08","L30.9","Z71.89","M51.27","M51.37","M47.817","E03.2","N32.89","N39.0","R06.02","R07.89"],"date":["2025-12-01","2023-04-18","2023-04-18","2023-04-18","2023-04-18","2025-12-01","2023-04-18","2023-04-18","2024-07-03","2023-04-18","2023-04-18","2025-10-13","2024-12-05","2025-07-07","2023-04-18","2023-06-23","2023-05-25","2023-05-25","2023-05-25","2024-07-10","2024-07-03","2025-12-23","2025-12-09","2025-11-24","2025-11-24","2025-11-24","2025-11-24","2025-11-24","2023-04-15","2023-04-15","2023-04-16","2023-04-15","2023-04-15","2025-12-23","2025-12-09","2025-12-07","2023-07-12","2024-07-11","2024-02-19","2025-10-13","2025-10-13","2024-05-23","2025-07-07","2023-04-15","2023-04-15","2025-12-01","2023-05-22","2023-05-22","2025-07-06","2025-06-04","2025-06-04","2025-06-10","2025-04-18","2023-02-08","2025-06-10","2024-12-05","2023-04-18","2023-06-23","2023-06-23","2025-07-06","2023-12-28","2023-04-16","2025-07-17","2025-07-17","2025-06-10","2025-12-01","2025-06-10","2025-06-10","2025-06-10","2024-02-19","2024-02-19","2023-12-28","2024-01-04","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-25","2025-08-01","2023-12-22","2025-07-11","2025-07-11","2024-07-11","2023-09-06","2023-12-20","2024-04-18","2025-07-06","2023-12-20","2024-07-01","2024-07-01","2023-12-22","2023-12-22","2023-12-22","2023-07-19","2026-02-08","2026-02-08","2026-02-10","2026-02-10"],"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":[["","","Cephalexin","500 MG","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Oxycodone-Acetaminophn 7.5-325","","","Select","Select",""],["","","Dicyclomine","10 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Pravastatin Sodium","20 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","Influenza A Virus A\/Darwin\/11\/2021 H3N2 Antigen","0.03 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","12 Hr Bupropion Hydrochloride","150 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Spironolactone","100 MG","","Select","Select",""],["","","Synthroid","175 MCG","","Select","Select",""],["","","Ezetimibe","10 MG","","Select","Select",""],["","","Flublok Trivalent 2024-25 Syrg","","","Select","Select",""],["","","Meloxicam","15 MG","","Select","Select",""],["","","Ammonium Lactate","120 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Oxycodone-Acetaminophen 10-325","","","Select","Select",""],["","","Hydromorphone","2 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Famotidine","20 MG","","Select","Select",""],["","","Tizanidine","4 MG","","Select","Select",""],["","","Cefpodoxime","100 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":""}]}]}