{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tiffany Nicely","gend":1,"currentgend":"","add":"1155 Mill St SE Apt D1","city":"Gainesville","state":"GA","zip":30501,"dob":"1971-03-11","age":"","mstatus":"","insh":"0005137552001","cliId":"","pno":4702741179,"cno":4702741179,"email":"tiffanynicely01@gmail.com","ename":"","eno":"","pphy":"Reena Jayani-Kosarzycki","ppno":6153223000,"pcpadd":"3601 THE VANDERBILT CLINIC","pcpcity":"NASHVILLE","pcpstate":"TN","pcpzip":37232,"pcpcounty":"","pcpid":"","pcpname":"3601 THE VANDERBILT CLINIC","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1155 Mill St SE Apt D1","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30501,"pcpfaxno":"","pcpnpi":1922397561,"currentgendcomment":"","pphycomment":"","uniqueid":374746,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C90.00","N18.32","R80.1","I10","R77.8","N06.1","Z51.11","D47.Z9","R93.2","E66.813","D17.71","Z98.84","Z94.84","M35.00","Z87.891","R21","Z68.36","E66.812","Z71.3","E66.01","Z68.41","M54.16","Z90.710","K08.499","I12.9","M35.05","Z87.440","D50.9","R76.8","C90.01","Z86.19","J31.0","J32.9","L29.9","H25.813","Z79.899","H04.123","H52.7","Z12.31","R73.03","D50.8","Z13.220","Z68.37","R22.9","Z68.35","N18.31","C79.51","D84.9","G47.33","C96.9","D72.819","N18.4","Z01.21","S02.5XX","J21.0","M54.59","M79.18","M48.061","N39.0","B96.20","Z68.33","R39.89","E55.9","D47.2","D63.1","K29.70","Z71.89","F32.3","F43.10","F41.1","Z68.34","R53.82","G89.3","K59.00","R11.0","R07.0","H66.002","E87.6","R51.9","Z80.9","Z13.31","M47.814","H10.33","J34.89","R05.1","K08.89","K02.9","J01.90","F41.9","F06.31","Z59.9","J06.9","J01.10","J02.9","R05.8","N30.00","K29.50","Z98.0","TRANS","F43.11","R35.0","Z02.71","Z00.00","F43.23","Z76.82","R53.81","R07.9","M89.9","M47.817","M54.6","F32.A","M65.4","T80.A19","M54.50","G89.29","K31.9"],"date":["2026-01-27","2026-02-20","2025-08-06","2025-10-23","2024-11-13","2024-11-13","2025-12-29","2024-10-10","2025-04-01","2025-04-01","2025-04-01","2025-07-31","2026-01-26","2026-01-26","2026-01-26","2025-12-29","2025-12-29","2025-12-29","2024-10-17","2025-10-23","2025-03-03","2026-01-19","2024-12-02","2025-10-16","2025-11-03","2024-07-02","2024-06-17","2024-09-03","2025-02-28","2026-01-15","2025-02-13","2025-09-15","2025-09-15","2025-09-15","2025-08-28","2025-08-28","2025-08-28","2025-08-28","2025-11-11","2026-02-20","2026-02-20","2026-02-20","2025-06-02","2024-12-10","2025-12-01","2025-11-03","2025-01-06","2026-01-15","2025-09-11","2024-10-10","2024-10-10","2024-12-02","2025-03-17","2025-02-28","2026-01-15","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2025-07-20","2025-08-06","2024-09-10","2024-09-10","2024-09-03","2024-10-24","2026-02-17","2026-02-16","2026-02-17","2026-02-16","2025-04-23","2025-04-23","2025-03-26","2025-04-23","2026-01-10","2026-01-10","2025-02-10","2024-10-23","2024-09-30","2024-11-04","2024-07-22","2025-09-07","2025-09-07","2025-09-07","2025-03-17","2025-03-17","2024-12-29","2025-02-19","2025-02-19","2024-12-12","2026-01-07","2025-12-06","2025-12-06","2025-12-06","2025-07-20","2024-09-03","2024-09-03","2025-05-30","2026-01-13","2025-08-13","2025-09-23","2025-02-05","2025-02-19","2025-02-19","2024-12-02","2024-10-04","2024-11-13","2024-07-22","2024-07-22","2025-10-23","2025-10-23","2024-11-04","2025-07-02","2025-07-02","2024-09-03"],"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":[["","","Ergocalciferol","1.25 MG","","Select","Select",""],["","","Cyclobenzaprine","10 MG","","Select","Select",""],["","","Pregabalin","50 MG","","Select","Select",""],["","","Eplerenone","25 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Lenalidomide","10 MG","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Losartan Potassium","25 MG","","Select","Select",""],["","","Acyclovir","400 MG","","Select","Select",""],["","","Aspirin","81 MG","","Select","Select",""],["","","Hydroxychloroquine Sulfate","200 MG","","Select","Select",""],["","","Fluoxetine","40 MG","","Select","Select",""],["","","Fentanyl","12 MCG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Potassium Chloride","20 MEQ","","Select","Select",""],["","","Morphine Sulfate","15 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Fluconazole","200 MG","","Select","Select",""],["","","Valacyclovir","500 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Prochlorperazine","10 MG","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Lorazepam","","","Select","Select",""],["","","Fluoxetine Hydrochloride","","","Select","Select",""],["","","Nitrofurantoin, Macrocrystals","25 MG","","Select","Select",""],["","","Hydroxyzine Pamoate","","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","5 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","Select","Select",""],["","","Fluticasone Propionate","","","Select","Select",""],["","","Levocetirizine Dihydrochloride","5 MG","","Select","Select",""],["","","Aripiprazole","5 MG","","Select","Select",""],["","","Promethazine Hydrochloride","12.5 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Dexamethasone","4 MG","","Select","Select",""],["","","Chlorhexidine Gluconate","","","Select","Select",""],["","","Levofloxacin","500 MG","","Select","Select",""],["","","Olanzapine","5 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Polymyxin B 10000 Unt\/Ml \/ Trimethoprim","1 MG","","Select","Select",""],["","","Tramadol Hydrochloride","","","Select","Select",""],["","","Promethazine Dm","","","Select","Select",""],["","","Prochlorperazine Maleate","","","Select","Select",""],["","","Diazepam","","","Select","Select",""],["","","Baclofen","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":""}]}]}