{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Anita Peters","gend":1,"currentgend":"","add":"238 Pine St","city":"Ringgold","state":"GA","zip":30736,"dob":"1963-05-18","age":"","mstatus":"","insh":"0005864367001","cliId":"","pno":4235802419,"cno":4235802419,"email":"apeters0518@gmail.com","ename":"","eno":"","pphy":"Kimberly Garland","ppno":4236988101,"pcpadd":"2515 DESALES AVE STE 206","pcpcity":"CHATTANOOGA","pcpstate":"TN","pcpzip":37404,"pcpcounty":"","pcpid":"","pcpname":"2515 DESALES AVE STE 206","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"238 Pine St","madd2":"","madd3":"","mcity":"Ringgold","mstate":"GA","mzip":30736,"pcpfaxno":4236983450,"pcpnpi":1104154137,"currentgendcomment":"","pphycomment":"","uniqueid":371108,"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":["D62","R65.10","K44.9","K31.7","K29.70","E78.00","R73.9","Z12.31","K25.9","K29.60","D50.0","K21.9","Z88.5","F41.1","R73.03","R79.89","F41.9","D50.8","E78.2","Z00.00","Z11.4","M85.859","Z12.11","Z12.12","K29.00","D64.9","K21.00","K22.2","Z83.71","Z86.010","Z01.419","D50.9","R11.10","K92.2","K92.1","R94.6","R92.30","Z87.42","L30.9","F43.23","Z79.899","Z12.4","Z11.51","K57.30","K25.7","K64.0","I49.3","R19.7","R19.5","R42","H61.23","Z76.89","U07.1","L03.113","L23.7","M81.0","E66.9","Z68.30","Z83.719","M85.89"],"date":["2024-05-08","2024-05-08","2024-06-25","2024-05-08","2024-05-07","2024-05-07","2024-05-10","2026-03-04","2024-06-26","2024-06-26","2024-06-26","2024-06-26","2024-06-26","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2026-01-14","2025-06-20","2025-06-20","2024-05-08","2024-05-10","2026-01-14","2024-10-09","2023-01-03","2024-10-09","2026-01-21","2024-10-09","2024-10-09","2024-05-23","2024-05-10","2024-05-10","2025-01-20","2025-01-20","2024-08-25","2024-01-08","2024-01-08","2025-01-20","2025-01-20","2023-04-28","2024-06-25","2023-04-28","2024-05-07","2024-05-08","2024-05-08","2024-05-08","2026-01-14","2024-05-23","2024-08-29","2024-08-29","2025-07-09","2023-09-21","2024-06-25","2024-06-25","2024-10-09","2023-09-21"],"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":[["","","Sertraline Hydrochloride","","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Citric Acid","75 MG","","Select","Select",""],["","","Pantoprazole Sod Dr","40 MG","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","Triamcinolone Acetonide","0.001 MG","","Select","Select",""],["","","Pantoprazole Sodium","","","Select","Select",""],["","","Famotidine","","","Select","Select",""],["","","Acetaminophen","21.7 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Lagevrio","200 MG","","Select","Select",""],["","","Prednisone","20 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":""}]}]}