{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Charles Keith Means","gend":0,"currentgend":"","add":"190 Chopped Oak Connector","city":"Toccoa","state":"GA","zip":30577,"dob":"1962-06-01","age":"","mstatus":"","insh":"0005247515002","cliId":"","pno":7062440526,"cno":"","email":"margiefmeanscpa@gmail.com","ename":"","eno":"","pphy":"Ram Reddy","ppno":7062457371,"pcpadd":"1399 BIG A RD","pcpcity":"TOCCOA","pcpstate":"GA","pcpzip":30577,"pcpcounty":"","pcpid":"","pcpname":"1399 BIG A RD","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"190 Chopped Oak Connector","madd2":"","madd3":"","mcity":"Toccoa","mstate":"GA","mzip":30577,"pcpfaxno":"","pcpnpi":1912097155,"currentgendcomment":"","pphycomment":"","uniqueid":365130,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J84.9","Z68.26","J18.9","I73.9","E78.5","I10","K21.9","Z79.02","Z79.82","Z79.899","Z87.891","Z96.641","R06.09","R91.1","Z51.81","Z68.25","J96.21","Z99.81","E87.1","H02.015","Z00.00","E78.1","R12","R05.2","R73.01","G47.00","E83.42","R00.0","Z20.822","I70.211","T82.856","Z68.24","R53.1","R93.89","R91.8","J20.9","J06.9","J84.89","Z23","R06.2","J16.8","J96.01","K62.1","Z12.11","Z11.52","Z87.01","E66.3","H16.142","H02.88A","H02.88B","H04.123","R07.9","R50.9","R06.02","J22","Z68.27","A41.9","Z12.5","R53.83","H25.13","Z01.812","Z01.818","Z85.038","K57.30","K64.0","D69.6","R09.02","H16.143","H52.4","H04.122","H16.141","J01.80","H02.9","Z98.890","Z29.9","J84.10","I70.213","R65.10","F51.01"],"date":["2026-01-22","2025-07-31","2025-01-13","2025-11-11","2024-12-27","2025-11-11","2025-01-02","2023-04-24","2025-01-02","2023-04-24","2025-01-02","2024-12-27","2025-05-06","2026-01-22","2026-01-22","2026-01-22","2025-01-02","2025-01-02","2025-11-11","2024-03-07","2025-05-14","2025-11-11","2025-11-11","2024-12-16","2025-11-11","2025-11-11","2025-11-04","2024-12-30","2025-04-15","2023-06-14","2023-06-14","2025-01-13","2024-02-16","2024-02-22","2025-07-31","2023-04-06","2023-03-09","2025-03-06","2025-03-06","2025-03-06","2024-12-30","2025-02-27","2024-12-11","2024-12-11","2024-12-27","2024-12-27","2024-12-27","2025-01-30","2025-01-30","2025-01-30","2025-01-30","2024-12-30","2025-07-31","2025-07-31","2025-04-15","2025-04-15","2023-04-24","2025-05-07","2025-05-07","2025-01-30","2023-06-02","2024-10-11","2024-12-11","2024-12-11","2024-12-11","2025-11-11","2023-04-23","2024-04-15","2024-11-06","2024-04-18","2024-04-11","2025-06-24","2024-03-07","2024-03-07","2024-12-26","2025-03-03","2023-06-14","2023-04-23","2023-12-21"],"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":[["","","Amitriptyline Hydrochloride","10 MG","","Select","Select",""],["","","Prednisolone Acetate","10 MG","","Select","Select",""],["","","Clopidogrel","75 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Fluticasone Propionate","0.05 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 Mg","","","Select","Select",""],["","","Erythromycin 0.5% Eye Ointment","","","Select","Select",""],["","","Dexamethasone","1 MG","","Select","Select",""],["","","Aspirin Ec","81 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Prednisone","5 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Albuterol","0.83 MG","","Select","Select",""],["","","Aspirin","81 MG","","Select","Select",""],["","","Albuterol Sulfate Hfa","","","Select","Select",""],["","","Mycophenolate Mofetil","500 MG","","Select","Select",""],["","","Flucelvax 2025-2026","","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","{3 Azithromycin","500 MG","","Select","Select",""],["","","Erythromycin","0.005 MG","","Select","Select",""],["","","Tobramycin-Dexameth Ophth Susp","","","Select","Select",""],["","","Moxifloxacin","5 MG","","Select","Select",""],["","","Atrovent","17 MCG","","Select","Select",""],["","","Aspirin Low Dose","","","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":""}]}]}