{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rebecca Carson","gend":1,"currentgend":"","add":"294 Harvest Church Rd","city":"Clarkesville","state":"GA","zip":30523,"dob":"1989-06-05","age":"","mstatus":"","insh":"0006369413002","cliId":"","pno":"404-944-4953","cno":7706347089,"email":"ianmcarson@yahoo.com","ename":"","eno":"","pphy":"Morris Pulliam","ppno":7702199260,"pcpadd":"73 MAXWELL LN","pcpcity":"DAHLONEGA","pcpstate":"GA","pcpzip":30533,"pcpcounty":"","pcpid":"","pcpname":"73 MAXWELL LN","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"294 Harvest Church Rd","madd2":"","madd3":"","mcity":"Clarkesville","mstate":"GA","mzip":30523,"pcpfaxno":"","pcpnpi":1508985607,"currentgendcomment":"","pphycomment":"","uniqueid":406710,"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":["R06.02","I49.1","Q21.12","I87.1","E46","R13.10","E05.80","G90.A","E28.2","E78.5","F32.A","Z68.1","Z68.20","A49.8","J30.89","L50.0","R06.00","R30.0","N89.8","I87.2","N94.89","R10.2","J02.9","R07.89","R94.31","J02.0","B37.0","R63.6","Z13.220","K52.9","K59.00","Z20.822","R31.9","R10.9","R76.8","N63.12","N64.4","G89.29","N30.90","H16.223","H01.02A","H01.02B","B88.0","H02.88A","H02.88B","H00.15","M79.661","N30.00","R10.31","R00.2","D89.42","M99.01","M54.2","M99.02","M54.6","M99.04","M62.830","M99.05","M54.51","I87.309","R07.9","M79.601","R39.9","M79.609","R53.1","R11.0","R07.0","R50.9","I95.1","I95.9","L70.0","L81.0","D23.72","L81.4","Z71.89","R00.0","I25.3","R05.1","J01.00","B37.9","K21.9","I10","J40","M79.662","K59.04","L50.9","T78.40X","B35.0","G90.89","D22.39","R21","F43.22","B37.81","M24.9","E55.9","Z79.899","Z00.00","E78.2","H92.02","Q43.8","R06.09","R07.2","B00.1","M79.605","J01.90"],"date":["2024-08-25","2024-08-25","2024-08-25","2026-01-14","2025-03-14","2024-12-20","2024-08-25","2024-11-25","2024-08-25","2024-08-25","2024-08-25","2026-02-19","2026-01-14","2025-04-17","2025-04-17","2025-04-17","2024-01-17","2025-07-21","2025-07-21","2024-05-23","2026-01-22","2024-07-22","2025-12-08","2024-08-24","2024-08-25","2026-02-26","2026-02-26","2025-03-26","2024-06-20","2024-03-06","2024-03-06","2025-06-05","2025-07-16","2026-01-22","2025-01-31","2026-02-11","2026-02-11","2026-01-22","2026-01-22","2025-02-27","2025-03-24","2025-03-24","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2024-03-04","2024-03-18","2026-02-18","2025-03-03","2025-04-17","2024-04-22","2024-04-22","2024-04-22","2024-04-22","2024-04-22","2024-04-22","2024-04-22","2024-04-22","2024-06-28","2024-08-25","2024-01-29","2024-04-25","2024-08-24","2024-08-24","2024-08-24","2024-08-24","2025-12-08","2025-10-08","2025-10-08","2025-05-21","2025-05-21","2025-05-21","2025-05-21","2025-05-21","2025-06-05","2024-07-23","2025-06-05","2025-06-05","2024-10-23","2024-10-23","2024-10-23","2024-08-24","2024-08-24","2026-02-18","2024-03-14","2024-03-14","2025-10-17","2025-04-09","2024-02-07","2025-10-08","2025-03-14","2024-08-20","2025-10-07","2024-12-13","2024-12-13","2024-10-30","2024-10-30","2024-10-30","2024-01-24","2024-01-24","2024-03-18","2024-03-18","2026-01-14","2025-06-13"],"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":[["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Hydroxyzine Hydrochloride","10 MG","","Select","Select",""],["","","Midodrine Hydrochloride","5 MG","","Select","Select",""],["","","Cromolyn Sodium","","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Nitrofurantoin, Macrocrystals","25 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Erythromycin","0.005 MG","","Select","Select",""],["","","Itraconazole","10 MG","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Ketoconazole","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":""}]}]}