{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James M Swan","gend":0,"currentgend":"","add":"7009 Dove Point Ln","city":"Hoschton","state":"GA","zip":30548,"dob":"1961-05-18","age":"","mstatus":"","insh":"0005949821001","cliId":"","pno":5052392240,"cno":"","email":"jswan28@msn.com","ename":"","eno":"","pphy":"Evan Hiner","ppno":7705342020,"pcpadd":"1400 RIVER PL","pcpcity":"BRASELTON","pcpstate":"GA","pcpzip":30517,"pcpcounty":"","pcpid":"","pcpname":"1400 RIVER PL","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"7009 Dove Point Ln","madd2":"","madd3":"","mcity":"Hoschton","mstate":"GA","mzip":30548,"pcpfaxno":"","pcpnpi":1821400441,"currentgendcomment":"","pphycomment":"","uniqueid":386976,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R26.89","R29.898","S76.119","G47.33","I50.21","J96.01","K76.1","E87.1","I48.91","I42.8","E78.5","J10.1","F17.210","Z79.899","I50.42","I50.22","Z23","Z00.00","I10","D22.9","K21.9","R74.01","F17.200","R10.31","Z76.0","Z12.11","Z68.21","L57.8","L82.0","L29.89","L53.8","Z78.9","L57.0","D64.9","R79.89","N28.9","S76.111","L82.1","I50.9","I48.0","I44.7","Z68.1","I11.0","J09.X2","F17.290","Z91.041","Z79.01","F10.11","I34.0","I50.23","Z87.891","H43.813","H25.13","Z12.5","R81","R73.9","N18.2","I13.0","E78.49","F41.8","Z91.030","Z68.22","Z13.1","E55.9","N40.1","M25.561","R07.9","H33.311","H43.811","H43.11","H43.391","S76.121","G89.18","I50.20","Z79.02","I42.9","K57.30","N32.89","R06.02","R60.0","H61.23","H61.21","R91.8","M17.11","I49.9","D50.9","Z68.20","S76.101","I36.1","I37.1","I51.9","Z28.20","Z09","R06.09","R63.4"],"date":["2024-02-27","2024-02-27","2024-02-27","2026-01-14","2025-11-17","2025-01-28","2025-01-27","2025-01-28","2026-01-15","2025-09-04","2025-11-11","2025-01-27","2025-01-27","2025-01-27","2025-07-11","2026-02-06","2025-11-17","2025-05-16","2025-11-11","2024-05-03","2024-05-03","2025-02-10","2024-05-03","2023-06-20","2023-05-01","2023-05-22","2024-05-03","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-06-13","2025-05-12","2025-05-12","2025-05-12","2024-05-29","2023-08-11","2025-11-17","2026-01-08","2026-01-08","2026-01-08","2025-12-04","2025-01-29","2025-01-27","2025-01-25","2025-12-04","2025-03-26","2025-07-31","2025-12-04","2025-12-04","2024-06-08","2024-08-26","2025-11-11","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2023-11-16","2023-04-26","2024-05-03","2025-08-07","2023-11-14","2025-12-03","2023-05-05","2024-08-26","2024-08-26","2024-08-26","2023-11-24","2023-11-24","2025-01-27","2025-01-27","2025-01-27","2023-06-20","2023-06-20","2025-02-10","2023-11-14","2024-10-24","2024-05-03","2025-01-24","2023-11-12","2025-12-03","2025-02-04","2025-02-04","2023-11-12","2025-01-24","2025-01-24","2025-01-24","2025-05-16","2025-02-10","2025-02-10","2025-02-10"],"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":[["","","Atorvastatin","10 MG","","Select","Select",""],["","","Famotidine","20 MG","","Select","Select",""],["","","Comirnaty 2023-24(12Y Up) Syrg","","","Select","Select",""],["","","24 Hr Metoprolol Succinate","50 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Tramadol Hcl","50 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","Flucelvax Trival 2024-2025 Syr","","","Select","Select",""],["","","Amiodarone Hydrochloride","200 MG","","Select","Select",""],["","","Farxiga","","","Select","Select",""],["","","Eliquis","","","Select","Select",""],["","","Losartan Potassium","25 MG","","Select","Select",""],["","","Spironolactone","25 MG","","Select","Select",""],["","","Furosemide","20 MG","","Select","Select",""],["","","Nda019430","0.3 ML","","Select","Select",""],["","","0.5 Ml Influenza A Virus A\/Darwin\/11\/2021 H3N2 Antigen","0.03 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Aspirin Ec","81 MG","","Select","Select",""],["","","72 Hr Scopolamine","0.0139 MG","","Select","Select",""],["","","Comirnaty 2024-25(12Y Up) Syrg","","","Select","Select",""],["","","Buspirone Hydrochloride","5 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":""}]}]}