{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeffrey Smith","gend":0,"currentgend":"","add":"2 Wild Ridge Ln","city":"Dahlonega","state":"GA","zip":30533,"dob":"1978-07-26","age":"","mstatus":"","insh":"0006166157001","cliId":"","pno":7703378361,"cno":"","email":"","ename":"","eno":"","pphy":"Robert Livingston","ppno":3865862010,"pcpadd":"1 ADVENTHEALTH WAY","pcpcity":"PALM COAST","pcpstate":"FL","pcpzip":32137,"pcpcounty":"","pcpid":"","pcpname":"1 ADVENTHEALTH WAY","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"2 Wild Ridge Ln","madd2":"","madd3":"","mcity":"Dahlonega","mstate":"GA","mzip":30533,"pcpfaxno":3864251304,"pcpnpi":1851465520,"currentgendcomment":"","pphycomment":"","uniqueid":403967,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","F41.9","M02.10","R22.41","M79.671","L53.9","M19.071","A41.9","Z87.39","Z53.29","F34.1","F10.20","T56.0X1","M10.132","M25.571","M86.9","K21.9","L03.032","L03.031","L97.519","L97.512","Z76.0","Z88.8","Z91.199","K76.0","E29.9","K51.918","M25.50","M25.422","D51.2","D51.9","R06.02","Z87.09","Z87.01","L97.528","E29.1","E55.9","M10.9","F10.280","M10.09","M10.061","R00.0","K04.7","M79.602","R79.82","M79.604","M10.022","M25.561","S91.102","S91.301","S91.302","Z20.822","R10.20","N50.0","R68.82","Z12.5","L98.9","R07.81","M47.816","K51.90","G89.11","M25.40","T14.8XX","L08.9","J30.1","J30.9","A08.4","M10.072","R00.2"],"date":["2026-02-22","2026-01-04","2025-12-04","2024-05-23","2024-05-17","2024-05-17","2024-05-17","2025-05-19","2025-10-22","2025-06-14","2025-02-05","2024-12-01","2025-08-08","2025-08-08","2024-05-23","2025-06-14","2025-02-05","2025-06-14","2025-06-14","2025-06-14","2025-06-14","2025-10-22","2025-10-22","2025-10-22","2024-03-08","2024-08-05","2024-08-19","2024-07-25","2024-03-08","2024-08-05","2024-08-05","2024-10-21","2024-10-21","2024-10-21","2025-06-14","2026-01-29","2024-08-05","2025-10-22","2024-07-10","2024-08-07","2025-12-20","2025-05-19","2024-08-19","2025-08-08","2024-05-07","2024-05-23","2026-01-07","2024-05-23","2025-05-19","2025-06-18","2025-06-18","2024-10-23","2026-01-29","2026-01-29","2026-01-29","2026-01-29","2025-03-20","2024-01-04","2024-08-07","2024-08-07","2024-05-17","2024-06-26","2025-05-19","2025-05-19","2025-02-05","2025-02-05","2025-02-05","2025-12-20","2025-08-08"],"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":[["","","Lisinopril","5 MG","","Select","Select",""],["","","Prednisone","50 MG","","Select","Select",""],["","","Gabapentin","400 MG","","Select","Select",""],["","","Amitriptyline Hydrochloride","25 MG","","Select","Select",""],["","","Promethazine Hydrochloride","25 MG","","Select","Select",""],["","","Potassium Chloride","10 MEQ","","Select","Select",""],["","","Ergocalciferol","1.25 MG","","Select","Select",""],["","","Alprazolam","0.5 MG","","Select","Select",""],["","","Colchicine","0.6 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Potassium Cl Er","10 MEQ","","Select","Select",""],["","","{21 Prednisone","10 MG","","Select","Select",""],["","","Atenolol","25 MG","","Select","Select",""],["","","Febuxostat","40 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Allopurinol","100 MG","","Select","Select",""],["","","Potassium Chloride Er","","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","1 Ml Testosterone Cypionate","200 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","10 MEQ","","Select","Select",""],["","","Vitamin B12","1 MG","","Select","Select",""],["","","Testosterone Cypionate","","","Select","Select",""],["","","Indomethacin","50 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 Mg","","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Acetaminophen-Cod #3 Tablet","","","Select","Select",""],["","","Nda020503 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Cyanocobalamin","","","Select","Select",""],["","","K-Phos","","","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":""}]}]}