{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John Burns","gend":0,"currentgend":"","add":"803 Shelton Dr","city":"Albany","state":"GA","zip":31705,"dob":"1963-12-28","age":"","mstatus":"","insh":"0005472604001","cliId":"","pno":2298810186,"cno":2298810186,"email":"darlenelburns65@gmail.com","ename":"","eno":"","pphy":"Mark Wood","ppno":2292281288,"pcpadd":"701 N SLAPPEY BLVD","pcpcity":"ALBANY","pcpstate":"GA","pcpzip":31701,"pcpcounty":"","pcpid":"","pcpname":"701 N SLAPPEY BLVD","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"803 Shelton Dr","madd2":"","madd3":"","mcity":"Albany","mstate":"GA","mzip":31705,"pcpfaxno":2292281322,"pcpnpi":1427152958,"currentgendcomment":"","pphycomment":"","uniqueid":336547,"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":["R07.89","R07.9","F17.200","J96.01","M62.82","E87.1","J10.1","E80.6","E77.8","E88.09","I10","F17.210","K76.0","K21.9","Z79.899","R05.9","M79.18","R03.0","R00.0","M54.31","J01.10","Z79.2","Z79.891","F12.90","K59.00","R06.02","M62.838","Z09","G93.31","R53.83","R09.89","Z13.1","Z13.29","Z13.6","I67.4","I95.1","E78.5","Z86.73","E78.2","I51.89","R68.82","Z12.5","N17.9","Z53.21","K60.2","H92.01","T16.1XX","R51.9","G93.41","R29.818","I16.1","E87.5","I51.7","K21.00","R94.31","I11.9","R94.39","K64.4","K62.89","R51.0","J01.40","R09.81","R05.1","H65.93","H66.001","I87.8","K56.41","R91.1","R10.13","E66.9","Z53.29","J02.0","J32.8","J30.2","Z12.11","Z12.12","R74.01","J01.90","H74.8X9","R79.89","N52.9","J30.1","J30.89","G44.209","J11.1","K64.8","L02.31"],"date":["2025-12-20","2026-01-06","2025-10-30","2025-12-21","2025-12-22","2025-12-22","2025-12-21","2025-12-21","2025-12-21","2025-12-21","2026-02-03","2025-12-21","2025-12-21","2025-12-21","2025-12-21","2025-02-25","2024-12-20","2024-06-07","2024-06-07","2024-02-28","2025-10-30","2025-10-30","2025-10-30","2025-10-03","2026-02-24","2026-01-06","2024-07-22","2026-01-09","2026-01-09","2026-01-09","2026-01-09","2026-01-09","2026-01-09","2026-01-09","2025-06-13","2025-06-13","2025-06-13","2025-09-25","2025-07-29","2025-07-01","2025-07-01","2025-07-09","2025-12-22","2026-02-10","2026-02-24","2025-10-05","2025-10-07","2025-10-30","2025-06-15","2025-06-15","2025-07-09","2025-06-15","2026-01-06","2025-07-29","2025-07-29","2025-07-29","2025-11-18","2026-02-03","2026-02-03","2025-07-09","2025-11-21","2025-11-21","2025-12-17","2025-11-21","2025-10-15","2026-01-06","2026-01-06","2025-06-12","2025-09-25","2025-09-25","2025-09-25","2025-02-21","2024-07-16","2024-02-28","2025-07-21","2025-07-21","2025-12-22","2025-09-04","2024-11-04","2025-12-21","2025-07-01","2024-02-21","2025-11-04","2025-10-30","2025-12-21","2025-09-04","2026-02-10"],"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":[["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Naproxen","500 MG","","Select","Select",""],["","","Selenium Sulfide","25 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Chlorhexidine Gluconate","","","Select","Select",""],["","","Losartan Potassium","100 MG","","Select","Select",""],["","","Famotidine","20 MG","","Select","Select",""],["","","Sucralfate","1000 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Hydrocortisone Acetate","25 MG","","Select","Select",""],["","","Hydrochlorothiazide","25 MG","","Select","Select",""],["","","Oseltamivir","30 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Albuterol Sulfate Hfa","","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Osmotic 24 Hr Nifedipine","60 MG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Aspirin","","","Select","Select",""],["","","Pantoprazole Sodium","","","Select","Select",""],["","","Hydrocortisone","25 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Fluticasone Propionate","0.05 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":""}]}]}