{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Amanda L Shannon","gend":1,"currentgend":"","add":"163 Burkhalter Dr","city":"Alto","state":"GA","zip":30510,"dob":"1967-12-12","age":"","mstatus":"","insh":"0005187944001","cliId":"","pno":7708834592,"cno":7708834592,"email":"upstate_lynng@yahoo.com","ename":"","eno":"","pphy":"Narendra Logendra","ppno":6787142070,"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":"163 Burkhalter Dr","madd2":"","madd3":"","mcity":"Alto","mstate":"GA","mzip":30510,"pcpfaxno":6786581957,"pcpnpi":1588602189,"currentgendcomment":"","pphycomment":"","uniqueid":373936,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I96","M86.171","M96.0","T84.223","B95.61","L08.9","E66.9","F32.A","F41.9","G62.9","K21.9","Z86.16","Z68.32","Z79.1","Z79.84","Z79.899","R73.03","I47.19","E83.39","I48.0","E86.0","I10","K56.7","Z89.511","A08.4","E83.42","Z90.49","K52.9","R74.8","E87.6","I45.10","Z79.85","N17.9","K85.30","E78.2","E87.1","G89.18","J02.9","J01.90","Z20.822","Z68.35","G47.33","R11.2","K29.00","M86.361","T84.7XX","M14.671","Z47.89","F33.0","G47.00","Z12.11","Z12.31","K85.90","E55.9","Z00.00","E11.610","Z00.01","R82.90","T84.498","M79.671","K63.89","R10.9","R60.0","Z09","Z89.519","Z98.890","I44.4","Z68.25","Z68.28","R05.9","R26.89","R29.6","R25.2","M86.9","J37.0","J39.2","F45.8","J34.89","J31.0","R13.14","Z91.89","Z86.69","Z68.34","L03.115","E53.8","M24.872","R09.81","A49.01","Z79.2","K56.609","K59.04","Z68.24","I45.19","R07.9","Z68.30","M86.661","R26.9","M79.672","Z87.39","E66.01","F43.21","E66.09","Z68.31","Z45.2","G47.10","R06.83","T84.69X","Z68.29","M86.671"],"date":["2023-02-17","2023-06-01","2023-02-17","2023-02-17","2023-02-17","2023-02-17","2024-08-14","2024-12-16","2026-02-13","2026-02-13","2026-02-13","2023-02-17","2023-09-01","2023-02-17","2023-02-17","2023-03-20","2025-06-13","2025-06-13","2024-12-16","2024-12-16","2024-12-16","2026-02-13","2024-12-16","2026-02-13","2024-12-16","2025-06-13","2024-12-16","2024-12-09","2024-12-16","2025-01-23","2024-12-09","2024-12-09","2024-12-10","2025-02-11","2026-02-13","2025-01-23","2023-06-21","2024-04-08","2024-04-08","2024-04-08","2026-01-05","2026-03-10","2024-12-16","2024-12-11","2023-06-21","2023-03-03","2023-06-28","2023-06-26","2026-02-13","2026-02-13","2026-02-13","2025-06-13","2024-12-09","2026-02-13","2026-02-13","2026-02-13","2026-02-13","2024-11-06","2024-11-01","2023-02-16","2024-12-09","2024-12-09","2023-02-05","2024-01-29","2024-01-29","2023-02-05","2024-12-10","2024-11-01","2024-08-14","2026-01-05","2026-01-05","2026-01-05","2026-01-05","2023-06-21","2024-04-15","2024-04-15","2024-04-15","2024-04-15","2024-04-15","2024-04-15","2023-03-20","2023-03-20","2023-12-19","2023-02-05","2026-02-13","2025-11-24","2023-01-26","2023-02-23","2023-02-23","2025-01-22","2025-01-22","2025-01-22","2024-12-09","2024-12-11","2023-06-01","2023-06-21","2024-06-10","2025-08-13","2024-04-03","2024-04-03","2024-04-03","2023-04-04","2023-04-04","2023-02-23","2025-07-18","2025-07-18","2023-02-18","2024-06-12","2023-06-26"],"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":[["","","Eszopiclone","2 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","150 MG","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Duloxetine","30 MG","","Select","Select",""],["","","24 Hr Metformin Hydrochloride","500 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","100 MG","","Select","Select",""],["","","Hydrochlorothiazide","25 MG","","Select","Select",""],["","","Amitriptyline Hydrochloride","100 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Dicyclomine","20 MG","","Select","Select",""],["","","Rosuvastatin Calcium","10 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Ezetimibe","10 MG","","Select","Select",""],["","","Silver Sulfadiazine","10 MG","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Clindamycin","300 MG","","Select","Select",""],["","","Temazepam","30 MG","","Select","Select",""],["","","Amitriptyline Hcl","100 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Cephalexin","250 MG","","Select","Select",""],["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Doxycycline Hyclate","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":""}]}]}