{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Johnny Ariemma","gend":0,"currentgend":"","add":"74 Grove St N","city":"Dahlonega","state":"GA","zip":30533,"dob":"1961-11-17","age":"","mstatus":"","insh":"0005765199001","cliId":"","pno":7064295418,"cno":7064295418,"email":"johnnyariemma@gmail.com","ename":"","eno":"","pphy":"Michael Mulberry","ppno":7068676505,"pcpadd":"725 JESSE JEWELL PKWY SE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013834,"pcpcounty":"","pcpid":"","pcpname":"725 JESSE JEWELL PKWY SE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"74 Grove St N","madd2":"","madd3":"","mcity":"Dahlonega","mstate":"GA","mzip":30533,"pcpfaxno":7068676505,"pcpnpi":1386696268,"currentgendcomment":"","pphycomment":"","uniqueid":369330,"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":["E78.2","I10","Z79.899","I25.10","R63.5","R06.09","Z71.2","G47.33","Z68.32","E66.811","Z68.33","R07.2","D69.6","R05.1","J01.41","Z20.822","Z12.5","Z00.00","K21.9","F33.2","Z91.09","M25.512","F33.40","Z68.34","J01.00","Z11.59","R31.0","D22.5","D22.72","N28.1","K42.9","Z00.01","Z13.89","D23.5","E66.9","I31.39","D73.89","Z12.11","Z12.12","R97.20","K42.0","J30.1","R09.81","J01.10","D69.49","Z13.31","Z20.828","R79.89","N30.00","N30.20","B35.1","D22.62","L81.4","L82.0","L53.8","D49.2","I37.1","J01.40","J01.90","B96.89","B15.9"],"date":["2026-02-11","2026-02-11","2023-05-26","2026-02-11","2023-12-05","2025-11-18","2025-09-02","2026-02-11","2026-02-11","2025-09-02","2026-02-11","2025-09-02","2026-02-11","2025-01-02","2025-01-02","2025-01-02","2026-02-05","2026-02-05","2026-02-11","2026-02-11","2026-02-11","2023-12-05","2024-01-16","2023-12-05","2024-12-17","2023-06-06","2023-08-01","2024-10-17","2024-08-02","2023-04-06","2026-02-09","2025-03-31","2025-03-31","2024-10-17","2024-08-06","2023-04-06","2023-04-06","2025-07-03","2025-07-03","2026-02-11","2025-04-14","2023-02-14","2023-02-14","2023-02-08","2023-06-06","2023-06-06","2023-06-06","2025-07-23","2023-04-05","2023-04-05","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2024-08-02","2025-11-18","2024-06-12","2023-12-22","2023-12-22","2023-06-22"],"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":[["","","Montelukast","5 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Metoprolol Succinate Er","","","Select","Select",""],["","","Amox-Clav 875-125 Mg Tablet","","","Select","Select",""],["","","Jublia 10% Topical Solution","","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Jublia","","","Select","Select",""],["","","Nitroglycerin","0.4 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":""}]}]}