{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sarah Gray Condrey","gend":1,"currentgend":"","add":"925 Mauldin Rd","city":"Sautee Nacoochee","state":"GA","zip":30571,"dob":"1964-05-29","age":"","mstatus":"","insh":"0005008785001","cliId":"","pno":7069693499,"cno":"","email":"Condreysarah8@gmail.com","ename":"","eno":"","pphy":"Lloyd Stuart","ppno":7067823100,"pcpadd":"541 HISTORIC HWY 441","pcpcity":"DEMOREST","pcpstate":"GA","pcpzip":30535,"pcpcounty":"","pcpid":"","pcpname":"541 HISTORIC HWY 441","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"925 Mauldin Rd","madd2":"","madd3":"","mcity":"Sautee Nacoochee","mstate":"GA","mzip":30571,"pcpfaxno":"","pcpnpi":1487665931,"currentgendcomment":"","pphycomment":"","uniqueid":236672,"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":["M25.531","S52.691","Z68.1","S16.1XX","Z87.891","J44.1","R06.02","J44.9","I10","F41.8","Z13.31","F17.210","Z00.00","Z11.59","E78.2","Z12.31","S20.211","R06.00","J10.1","F17.200","Z12.2","J43.9","R06.09","S19.9XX","J16.8","J20.9","Z72.0","R07.9","V89.2XX","R10.9","M65.4","M25.541","R91.1","K57.90","R10.84","J18.9","J22","W19.XXX"],"date":["2025-11-06","2026-01-29","2026-01-29","2025-04-16","2025-05-09","2026-01-06","2025-09-29","2026-02-24","2025-03-04","2025-03-04","2025-03-04","2026-02-24","2025-03-04","2025-03-04","2025-03-04","2025-03-04","2025-04-16","2025-02-04","2025-02-05","2024-05-13","2025-05-08","2025-07-07","2025-05-09","2025-04-16","2025-07-07","2025-02-05","2025-02-05","2025-04-16","2025-04-16","2025-04-16","2025-12-15","2025-12-15","2025-11-20","2024-03-10","2024-03-10","2025-07-07","2025-06-23","2025-11-02"],"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":[["","","Advair Hfa 115-21 Mcg Inhaler","","","Select","Select",""],["","","Nda020503 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Advair Hfa","","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Trelegy Ellipta","","","Select","Select",""],["","","Nicotine Transdermal System","","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Diclofenac Sodium","50 MG","","Select","Select",""],["","","Spiriva Respimat","","","Select","Select",""],["","","Combivent Respimat","","","Select","Select",""],["","","Ipratropium Bromide\/Albuterol Sulfate","","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","24 Hr Nicotine","0.875 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","150 MG","","Select","Select",""],["","","Breztri Aerosphere","","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Stiolto Respimat","","","Select","Select",""],["","","{11 Varenicline","0.5 MG","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","Ondansetron","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":""}]}]}