{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Chaise Patton","gend":0,"currentgend":"","add":"62 Laurel Park Dr","city":"Cleveland","state":"GA","zip":30528,"dob":"1991-07-20","age":"","mstatus":"","insh":"0005873256001","cliId":"","pno":8127975617,"cno":8127975617,"email":"Ghostpatton@gmail.com","ename":"","eno":"","pphy":"Ayham Haddad","ppno":7705320800,"pcpadd":"142 PARKWAY PLZ","pcpcity":"CLEVELAND","pcpstate":"GA","pcpzip":30528,"pcpcounty":"","pcpid":"","pcpname":"142 PARKWAY PLZ","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"62 Laurel Park Dr","madd2":"","madd3":"","mcity":"Cleveland","mstate":"GA","mzip":30528,"pcpfaxno":7705320801,"pcpnpi":1952398406,"currentgendcomment":"","pphycomment":"","uniqueid":367067,"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":["C73","R59.0","C79.89","E89.0","Z85.841","J34.3","E04.1","H69.93","Z68.32","S61.431","Z23","Z68.33","Z68.31","S93.401","F41.1","C71.9","J02.9","R05.1","J01.90","B96.89","S99.911","Z88.0","Z92.3","C71.2","R21","L20.84","B35.1","B36.0","Z79.899","M25.571","S82.391","R60.9","Z92.21","Z98.890"],"date":["2025-05-09","2024-01-24","2023-11-21","2024-05-08","2025-07-18","2025-05-09","2025-05-09","2025-05-09","2025-05-09","2023-06-14","2023-06-14","2025-01-17","2026-03-21","2025-08-27","2024-10-18","2024-07-05","2026-03-21","2026-03-21","2026-03-21","2026-03-21","2025-08-27","2024-01-03","2024-01-03","2025-07-18","2023-05-17","2023-05-17","2025-01-16","2025-01-16","2025-01-16","2025-08-28","2025-08-28","2023-06-30","2023-06-30","2025-07-18"],"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":[["","","Levothyroxine Sodium","0.15 MG","","Select","Select",""],["","","Jublia","","","Select","Select",""],["","","Ketoconazole","20 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Terbinafine","250 MG","","Select","Select",""],["","","Jublia 10% Topical Solution","","","Select","Select",""],["","","Ketoconazole 2% Shampoo","","","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":""}]}]}