{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Emma Louise Martin","gend":1,"currentgend":"","add":"417 Pine Dr","city":"Dahlonega","state":"GA","zip":30533,"dob":"1962-07-02","age":"","mstatus":"","insh":"0006646543001","cliId":"","pno":7069743082,"cno":7069743082,"email":"martin.emmalouise@gmail.com","ename":"","eno":"","pphy":"Ugochukwu Egolum","ppno":7705342020,"pcpadd":"743 SPRING ST NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013715,"pcpcounty":"","pcpid":"","pcpname":"743 SPRING ST NE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"417 Pine Dr","madd2":"","madd3":"","mcity":"Dahlonega","mstate":"GA","mzip":30533,"pcpfaxno":"","pcpnpi":1558687384,"currentgendcomment":"","pphycomment":"","uniqueid":387481,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G47.419","I10","E03.9","I50.9","I48.91","Z11.1","Z95.810","I42.9","Z83.3","I83.893","M79.671","M79.89","I50.42","I42.8","I73.9","I87.2","I65.23","M79.604","M79.605","M54.50","I44.7","I38","R11.0","N18.9","I36.1","I37.1","Z68.22","Z79.899","J40","Z45.02","I34.0","D50.9","N18.32","Z95.818","M79.672","N20.0","E78.2","L53.9","Z68.24","Z68.20"],"date":["2026-02-23","2026-02-23","2026-02-23","2026-03-09","2025-09-12","2024-04-19","2025-06-13","2025-06-13","2024-12-23","2026-03-09","2026-03-09","2026-03-09","2025-06-13","2025-06-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2025-06-09","2024-05-15","2023-04-28","2023-04-28","2025-06-09","2025-06-09","2025-06-13","2025-09-12","2024-12-23","2025-06-13","2025-06-09","2025-06-09","2025-09-12","2024-09-23","2026-03-07","2026-02-23","2025-01-02","2026-03-07","2026-03-07","2023-11-07"],"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":[["","","Amphetamine Aspartate","5 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","Digoxin","0.125 MG","","Select","Select",""],["","","Entresto","24 MG","","Select","Select",""],["","","Furosemide","20 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.112 MG","","Select","Select",""],["","","Spironolactone","25 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Farxiga","10 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","Acetaminophen","300 MG","","Select","Select",""],["","","Sacubitril\/Valsartan","","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Atorvastatin","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":""}]}]}