{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kenneth R Vandusen","gend":0,"currentgend":"","add":"3840 Damascus Church Rd","city":"Dahlonega","state":"GA","zip":30533,"dob":"1963-12-10","age":"","mstatus":"","insh":"0005494184001","cliId":"","pno":7069698480,"cno":7069698480,"email":"kennyv43@gmail.com","ename":"","eno":"","pphy":"Mark Moers","ppno":7068643323,"pcpadd":"95 MORRISON MOORE PKWY W STE 100","pcpcity":"DAHLONEGA","pcpstate":"GA","pcpzip":30533,"pcpcounty":"","pcpid":"","pcpname":"95 MORRISON MOORE PKWY W STE 100","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"3840 Damascus Church Rd","madd2":"","madd3":"","mcity":"Dahlonega","mstate":"GA","mzip":30533,"pcpfaxno":7068644484,"pcpnpi":1962495234,"currentgendcomment":"","pphycomment":"","uniqueid":366574,"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":["L90.5","L91.8","D22.5","L82.1","L81.4","Z71.89","L57.0","I10","G47.33","I25.10","I25.84","Z68.33","F41.1","C15.9","G47.30","F43.23","F33.2","E78.01","Z12.11","K31.84","Z86.010","K31.7","D12.0","Z90.49","K57.30","Z85.01","E11.9","Z00.00","Z23","E66.1","F32.A","R13.19","Z68.36","C16.0","E66.8","Z92.21","Z92.3","F33.0","Z87.891","Z68.34","M51.360","M51.362","L21.9","I25.119","K21.9","E29.1","R73.03","Z79.82","Z79.899","G47.00","F51.5","H53.433","E78.1","E78.019","R97.0","Z68.35","E66.812","U07.1","S30.0XX","L21.8","L53.8","L57.8","Z00.01","Z12.5","Z63.79","Z63.9","T18.2XX","I65.23","H25.813","H40.013","H52.4","H47.231","H52.03","H52.222","H40.003","R94.30","R93.1","Z59.86","K29.70","F41.8","H40.051","Q39.8","R03.0","M51.369","M47.817","L71.8","D18.01","G56.01","F32.89","J01.80"],"date":["2025-05-02","2025-05-02","2025-05-02","2025-05-02","2025-05-02","2025-05-02","2025-05-02","2026-03-16","2026-03-16","2024-01-10","2023-11-14","2026-03-16","2026-01-12","2024-03-01","2026-01-12","2024-03-01","2026-01-12","2025-09-15","2025-02-26","2025-02-26","2026-01-06","2025-02-26","2025-02-26","2025-02-26","2025-02-26","2026-01-06","2026-03-16","2024-09-05","2025-09-15","2024-09-05","2026-03-16","2025-03-12","2025-02-14","2025-05-19","2023-09-25","2025-05-19","2025-05-19","2025-05-19","2025-05-19","2025-09-15","2026-03-16","2026-03-16","2026-03-16","2026-03-16","2026-01-06","2023-09-01","2024-01-10","2024-01-10","2024-02-27","2025-12-02","2026-01-12","2023-05-01","2025-12-01","2026-03-10","2025-05-19","2026-01-06","2025-05-19","2023-11-27","2023-08-31","2024-04-26","2023-04-17","2023-04-17","2025-09-15","2025-09-09","2024-01-08","2023-11-16","2024-01-10","2025-02-06","2024-06-24","2024-06-24","2024-06-24","2023-04-10","2024-06-24","2024-06-24","2024-06-24","2023-12-18","2023-12-18","2024-01-08","2025-02-26","2023-10-30","2024-06-24","2024-01-10","2026-01-06","2025-08-11","2025-08-11","2024-04-26","2024-04-26","2025-03-12","2023-02-20","2023-02-20"],"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":[["","","Simvastatin","40 MG","","Select","Select",""],["","","Escitalopram","10 MG","","Select","Select",""],["","","Fluticasone Prop","50 MCG","","Select","Select",""],["","","Fluoxetine","20 MG","","Select","Select",""],["","","Hydrocortisone","25 MG","","Select","Select",""],["","","Ketoconazole","20 MG","","Select","Select",""],["","","Ibuprofen","600 MG","","Select","Select",""],["","","Lorazepam","1 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","24 Hr Desvenlafaxine Succinate","100 MG","","Select","Select",""],["","","Paxlovid 300-100 Mg Pack (Eua)","","","Select","Select",""],["","","Prazosin","1 MG","","Select","Select",""],["","","Aripiprazole","2 MG","","Select","Select",""],["","","Buspirone Hydrochloride","10 MG","","Select","Select",""],["","","Mounjaro","5 MG","","Select","Select",""],["","","Prazosin Hydrochloride","","","Select","Select",""],["","","Rosuvastatin Calcium","10 MG","","Select","Select",""],["","","Fenofibrate","145 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Vilazodone Hydrochloride","10 MG","","Select","Select",""],["","","Alprazolam","1 MG","","Select","Select",""],["","","Magnesium Sulfate","225 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","150 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 Mg","","","Select","Select",""],["","","Diazepam","5 MG","","Select","Select",""],["","","Benzonatate","100 MG","","Select","Select",""],["","","Hydroxyzine Hcl","25 MG","","Select","Select",""],["","","Amoxicillin","500 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":""}]}]}