{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Creig Alsandor","gend":0,"currentgend":"","add":"157 Vinson Rd","city":"Boston","state":"GA","zip":"31626","dob":"1970-09-26","age":"","mstatus":"","insh":"0005033516001","cliId":"","pno":"2294213102","cno":"2294213102","email":"creigalsandor@yahoo.com","ename":"","eno":"","pphy":"Karen Lee","ppno":"2292366742","pcpadd":"1019 E JACKSON ST","pcpcity":"THOMASVILLE","pcpstate":"GA","pcpzip":"31792","pcpcounty":"","pcpid":"","pcpname":"1019 E JACKSON ST","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"157 Vinson Rd","madd2":"","madd3":"","mcity":"Boston","mstate":"GA","mzip":"31626","pcpfaxno":"2292366746","pcpnpi":"1730521022","currentgendcomment":"","pphycomment":"","uniqueid":"343568","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":["Q24.5","I10","E78.5","F17.210","I83.812","Z79.899","Z82.49","M54.30","B34.8","Z79.82","J44.1","R06.02","I20.0","I83.813","M54.41","M54.59","I25.10","J41.0","Z12.5","Z79.01","I20.9","R37","Z13.6","I87.2","R03.0","R30.0","M54.50","M51.36","Z87.891","I25.110","N52.9","Z12.11","Z01.818","R05.1","F17.201"],"date":["2026-01-19","2026-05-27","2023-11-13","2026-01-19","2023-10-30","2026-05-27","2023-10-25","2026-05-01","2026-05-27","2026-05-27","2026-05-27","2026-05-27","2023-10-23","2023-09-19","2023-10-17","2023-03-21","2026-01-19","2026-01-19","2026-01-19","2023-10-23","2023-10-23","2023-08-21","2023-08-21","2023-09-26","2023-09-26","2023-04-28","2023-06-02","2023-10-30","2023-06-01","2023-10-25","2023-10-30","2023-04-28","2023-10-23","2023-02-23","2023-11-13"],"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":[["","","ROSUVASTATIN CALCIUM","40000 MG","","Select","Select",""],["","","PROMETHAZINE-DM","6.25-15\/5","","Select","Select",""],["","","BREZTRI AEROSPHERE","0","","Select","Select",""],["","","CARVEDILOL","6.25 MG","","Select","Select",""],["","","CELECOXIB","100000 MG","","Select","Select",""],["","","TRELEGY ELLIPTA","0","","Select","Select",""],["","","ALBUTEROL SULFATE","83 %","","Select","Select",""],["","","AZITHROMYCIN","250000 MG","","Select","Select",""],["","","PREDNISONE","20000 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":""}]}]}