{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeffrey Spence","gend":0,"currentgend":"","add":"6418 Deep Valley Ct","city":"Flowery Branch","state":"GA","zip":30542,"dob":"1968-02-08","age":"","mstatus":"","insh":"0005817116001","cliId":"","pno":6786654579,"cno":6786654579,"email":"jeffspence208@gmail.com","ename":"","eno":"","pphy":"Courtney Anderson","ppno":7064757055,"pcpadd":"1199 PRINCE AVE","pcpcity":"ATHENS","pcpstate":"GA","pcpzip":30606,"pcpcounty":"","pcpid":"","pcpname":"1199 PRINCE AVE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"6418 Deep Valley Ct","madd2":"","madd3":"","mcity":"Flowery Branch","mstate":"GA","mzip":30542,"pcpfaxno":"","pcpnpi":1972965887,"currentgendcomment":"","pphycomment":"","uniqueid":384656,"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":["K85.20","F10.10","I48.92","I10","K31.84","E78.49","E03.9","E78.5","K21.9","K86.81","K85.01","Z68.25","J18.9","J91.8","D75.838","E78.1","Z79.899","R65.10","J90","E83.39","F32.A","F41.1","E78.2","G47.33","F95.2","R45.1","R61","Z91.199","Z53.21","K29.80","E83.42","F41.9","K86.0","R59.0","Z85.828","H25.11","E43","Z79.890","Z23","Z68.26","K86.1","Z91.041","R00.0","M79.641","M25.511","J18.1","J98.11","Z46.59","Z48.813","K85.90","J98.4","K63.89","K85.91","Z00.00","R73.09","G47.00","K85.21","H43.813","Z96.1","T85.898","R10.13","M25.562","M25.551","M17.12","M16.11","R10.0","G89.18","L57.0","D22.5","K81.1","Z12.83","D48.5","L82.1","D22.9","D18.01","L91.8","J20.9","K30","F10.188","R84.6","J06.9","K85.80","M23.232","R50.9","R11.2","R10.10","K80.10","R59.9","D72.829","F10.21","Z68.27","R21","R93.5","R94.4","R73.03","Z78.9","J16.8","R53.83","R68.82","R91.8","R07.9","L11.1","H25.12","M23.612","M23.322","M23.352","L21.9","S83.282","M75.51","M77.8","R29.898","G89.29","K82.8","K86.89","K80.20","L30.9","L29.9","R06.02","K86.3","I49.9","M23.92","K85.02","F10.939","R50.81","U07.1","I11.9"],"date":["2024-11-04","2024-11-26","2024-11-07","2026-03-10","2025-03-27","2024-10-27","2026-03-10","2026-03-10","2026-03-10","2025-11-19","2025-11-19","2025-04-23","2024-11-07","2024-11-07","2024-11-07","2024-11-07","2025-02-22","2024-11-07","2024-11-07","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2026-03-10","2024-12-06","2025-05-13","2025-05-13","2025-11-17","2025-01-18","2025-02-22","2025-01-18","2025-01-18","2025-11-19","2025-02-22","2025-02-22","2023-05-19","2023-05-19","2024-11-05","2024-11-05","2024-11-05","2024-11-05","2025-12-09","2024-11-05","2024-11-05","2025-11-19","2025-06-03","2026-03-10","2025-12-09","2024-11-13","2026-02-20","2026-02-20","2025-03-03","2024-10-27","2025-04-02","2025-04-02","2025-04-23","2025-04-02","2024-10-24","2025-05-13","2025-10-02","2024-12-09","2025-05-13","2025-10-02","2025-10-02","2024-12-09","2025-10-02","2025-10-02","2024-12-09","2024-12-09","2025-01-07","2024-10-28","2024-10-31","2023-08-22","2024-10-27","2025-04-23","2025-02-20","2024-10-27","2024-10-24","2025-05-13","2025-05-13","2025-02-22","2025-11-19","2025-11-19","2024-11-27","2024-10-24","2024-10-24","2024-10-24","2024-10-24","2024-10-27","2026-03-10","2026-03-10","2024-10-30","2024-10-25","2024-12-06","2025-12-17","2025-04-18","2025-04-18","2025-04-18","2025-10-02","2025-04-18","2023-05-19","2023-05-19","2023-05-19","2023-05-19","2024-10-25","2025-02-21","2025-02-21","2024-11-22","2024-11-22","2024-10-27","2025-01-07","2024-10-26","2025-01-08","2025-02-14","2024-11-02","2024-11-02","2023-08-22","2024-10-29"],"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":[["","","Naproxen","500 MG","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Trazodone Hydrochloride","50 MG","","Select","Select",""],["","","Clonazepam","0.5 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.125 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Atorvastatin","80 MG","","Select","Select",""],["","","Fluoxetine","40 MG","","Select","Select",""],["","","Fenofibrate","160 MG","","Select","Select",""],["","","Codeine Phosphate","2 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Pantoprazole Sod Dr","40 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Calcipotriene","0.05 MG","","Select","Select",""],["","","Creon Dr 36,000 Unit Capsule","","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Creon","","","Select","Select",""],["","","Methylprednisolone","32 MG","","Select","Select",""],["","","Tramadol Hydrochloride","","","Select","Select",""],["","","Pantoprazole Sodium","","","Select","Select",""],["","","Prednisolone Acetate","10 MG","","Select","Select",""],["","","Polymyxin B 10000 Unt\/Ml \/ Trimethoprim","1 MG","","Select","Select",""],["","","Paxlovid 300-100 Mg Pack (Eua)","","","Select","Select",""],["","","Triamcinolone Acetonide","5 MG","","Select","Select",""],["","","Metoclopramide","10 MG","","Select","Select",""],["","","Ketoconazole","20 MG","","Select","Select",""],["","","Fluocinolone Acetonide","0.1 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Celecoxib","200 MG","","Select","Select",""],["","","Gabapentin","300 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":""}]}]}