{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Melvin Carr","gend":0,"currentgend":"","add":"91 Hugh St","city":"Thomasville","state":"GA","zip":31792,"dob":"1961-01-07","age":"","mstatus":"","insh":"0005794452001","cliId":"","pno":2292217218,"cno":2292217218,"email":"rogersdilene@yahoo.com","ename":"","eno":"","pphy":"Christian Trujillo","ppno":2295845731,"pcpadd":"2705 E PINETREE BLVD STE C","pcpcity":"THOMASVILLE","pcpstate":"GA","pcpzip":31792,"pcpcounty":"","pcpid":"","pcpname":"2705 E PINETREE BLVD STE C","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"91 Hugh St","madd2":"","madd3":"","mcity":"Thomasville","mstate":"GA","mzip":31792,"pcpfaxno":"","pcpnpi":1710408554,"currentgendcomment":"","pphycomment":"","uniqueid":362414,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R91.8","Z20.822","J84.10","N32.9","K57.30","K44.9","B96.89","N13.8","I50.32","I11.0","N40.1","E78.2","I25.10","Z46.6","Z79.899","Z79.84","R50.9","R05.9","A41.9","I10","E78.00","I51.7","R31.9","R39.14","R33.9","I50.30","N40.0","N41.9","H40.112","Z12.5","J11.1","Z12.11","Z12.12","J98.4","J92.9","R10.A0","K59.00","K57.90","R59.0","H25.813","U07.1","N32.0","N30.00","N39.0","R00.0","M54.50","A41.89","J10.1","M54.9","N41.0","R94.31"],"date":["2026-01-16","2025-12-11","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-10","2025-11-08","2025-12-11","2025-11-26","2025-12-11","2025-12-11","2025-12-11","2025-11-08","2025-11-26","2025-11-08","2025-12-11","2025-12-11","2025-11-07","2025-12-15","2024-02-19","2025-12-11","2025-11-12","2025-11-12","2025-11-01","2025-11-13","2025-11-13","2025-12-03","2026-03-23","2025-12-15","2025-12-15","2025-06-22","2025-06-22","2026-01-28","2026-01-28","2025-11-26","2025-11-26","2025-11-26","2025-11-07","2024-08-15","2024-09-21","2025-11-21","2025-11-12","2025-11-10","2025-11-07","2025-11-26","2025-11-12","2025-12-11","2025-11-10","2025-11-12","2023-02-21"],"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":[["","","Rosuvastatin Calcium","10 MG","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Latanoprost","0.05 MG","","Select","Select",""],["","","Dorzolamide","20 MG","","Select","Select",""],["","","Losartan Potassium","100 MG","","Select","Select",""],["","","Jardiance","10 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Hydralazine Hydrochloride","50 MG","","Select","Select",""],["","","12 Hr Timolol","5 MG","","Select","Select",""],["","","24 Hr Isosorbide Mononitrate","30 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Finasteride","5 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Nda021457 200 Actuat Albuterol","0.09 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":""}]}]}