{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Marvin L Donaldson","gend":0,"currentgend":"","add":"535 Lovell Rd","city":"Toccoa","state":"GA","zip":30577,"dob":"1968-05-17","age":"","mstatus":"","insh":"0005923063001","cliId":"","pno":7067160069,"cno":7067160069,"email":"lee.donaldson0517@gmail.com","ename":"","eno":"","pphy":"Christopher Kiker","ppno":7068863148,"pcpadd":"58 BIG A RD","pcpcity":"TOCCOA","pcpstate":"GA","pcpzip":30577,"pcpcounty":"","pcpid":"","pcpname":"58 BIG A RD","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"535 Lovell Rd","madd2":"","madd3":"","mcity":"Toccoa","mstate":"GA","mzip":30577,"pcpfaxno":"","pcpnpi":1679908057,"currentgendcomment":"","pphycomment":"","uniqueid":376585,"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":["A63.0","K62.5","K21.9","Z91.81","K62.82","Z68.23","M25.552","K29.70","Z12.5","M50.10","M15.9","Z00.00","A09","Z12.11","K62.89","R63.4","R11.0","R11.10","R16.0","Z12.12","N20.0","K52.9","K51.20","L03.113","R09.89","R11.2","R10.84","M25.559","M47.816","M51.27","M85.80","M43.16","S72.002","Y93.89","G62.9","S72.001","Z53.9","R19.7","Z68.22","Z96.642","L90.5","K25.9","K44.9","K62.0","K57.30","Z11.59","D01.3","K29.00","K25.3","B02.9","Z47.1","Z20.822","W18.39X","L92.9"],"date":["2024-02-29","2023-10-23","2023-10-23","2025-11-12","2024-02-29","2025-03-24","2026-03-10","2023-09-06","2024-03-19","2024-03-18","2024-03-18","2025-03-24","2023-07-13","2025-06-16","2023-10-23","2023-08-17","2023-08-17","2023-08-17","2023-08-17","2025-06-16","2023-07-10","2023-08-15","2023-08-15","2024-07-11","2023-08-15","2023-08-15","2023-08-15","2025-11-12","2025-11-12","2025-11-12","2025-11-12","2025-11-12","2025-11-13","2025-11-12","2025-11-13","2025-11-13","2023-08-15","2023-08-15","2023-07-07","2026-03-10","2024-07-24","2023-08-15","2023-08-15","2023-08-15","2023-08-15","2024-03-19","2023-10-23","2023-08-30","2023-08-30","2024-10-18","2026-03-10","2024-03-19","2025-11-12","2024-07-26"],"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":[["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Hydromorphone Hcl","","","Select","Select",""],["","","Celecoxib","200 MG","","Select","Select",""],["","","Pregabalin","75 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":""}]}]}