{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Bobby Collins","gend":0,"currentgend":"","add":"65 Blackburn Rd","city":"Cleveland","state":"GA","zip":30528,"dob":"1969-11-19","age":"","mstatus":"","insh":"0007163653002","cliId":"","pno":7069692330,"cno":7069692330,"email":"","ename":"","eno":"","pphy":"Jagindra Mangru","ppno":7708875159,"pcpadd":"3970 DEPUTY BILL CANTRELL MEMORIAL ROAD SUITE 203","pcpcity":"CUMMING","pcpstate":"GA","pcpzip":30041,"pcpcounty":"","pcpid":"","pcpname":"3970 DEPUTY BILL CANTRELL MEMORIAL ROAD SUITE 203","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"65 Blackburn Rd","madd2":"","madd3":"","mcity":"Cleveland","mstate":"GA","mzip":30528,"pcpfaxno":7708879496,"pcpnpi":1922028034,"currentgendcomment":"","pphycomment":"","uniqueid":291395,"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":["R19.03","J40","R06.02","M51.36","H92.03","J02.9","M19.90","E05.90","G89.29","R53.83","R11.10","R19.7","R10.84","M06.9","I50.32","I11.0","R11.2","R10.9","R06.2","Z20.828","Z20.818","R07.1","R50.9","J18.9","J22","Z12.5","M54.50","R53.82","R26.81","I10","M40.04","I70.8","G44.219","M54.31","M51.86","Z68.28","G43.711","Z68.27","E05.00","M21.371","M54.9","F41.9","E21.3","J45.909","K85.00","E87.5","R06.09","M54.2","M54.6","R63.4","R39.15","G43.709","R42","R03.0","Z68.32","I25.10","Z79.01","Z86.73","J01.90","J30.9","R09.81","M47.816","I65.23","E78.2","R00.2","F17.220","I72.0","G43.909","K59.1","K21.9","G62.9","G44.89","Z79.02","Z79.1","Z79.899","Z92.3","Z85.46","R55","R41.3","Z68.29","M54.16","R05.1","M79.12","Z20.822","M17.9","Z68.30","M05.69","D34","M10.361","F34.1","F32.9","B35.1","H02.534","H30.23","E89.0","Z76.89","M17.11","I16.0","R10.31","L08.9","J20.9","L29.9","F32.1","R53.1","I63.9","R32","Z68.26","F06.70","Z68.33","E86.0","R31.29","R11.0","R11.12","Z68.25","G47.33","E66.3","R51.9","R79.89","I11.9","Z01.818","Z68.24","M50.323","M13.861","F90.2","E03.9","C61","D63.8","I49.3","R30.0","N17.9","Z99.89","E66.811","I67.89","K42.9","K57.30","M51.27","M51.370","H66.93","K59.00","G43.719"],"date":["2024-08-13","2024-12-09","2025-11-18","2024-06-18","2024-06-18","2026-01-19","2024-12-29","2026-03-13","2025-11-10","2025-07-28","2025-02-17","2025-02-17","2024-12-26","2025-09-05","2025-12-16","2025-12-16","2025-01-24","2024-12-29","2025-07-28","2025-03-21","2025-01-24","2025-07-28","2025-07-28","2025-07-28","2025-07-28","2024-10-21","2025-11-10","2025-03-24","2024-07-22","2025-04-22","2024-09-04","2024-09-04","2024-09-04","2024-09-04","2024-09-04","2024-08-27","2025-12-03","2025-01-02","2025-09-30","2024-04-03","2024-04-03","2025-11-10","2024-04-03","2024-04-03","2024-04-03","2024-04-03","2025-11-19","2025-05-28","2025-02-14","2025-02-14","2025-02-14","2025-11-19","2025-12-16","2024-12-09","2025-04-22","2025-12-16","2025-12-16","2025-12-16","2026-01-19","2025-07-28","2025-07-28","2026-03-02","2026-02-16","2025-12-16","2025-11-04","2024-12-29","2026-02-11","2024-12-29","2024-12-29","2025-09-05","2024-12-29","2024-12-29","2024-12-29","2024-12-29","2026-03-02","2024-12-29","2024-12-29","2025-04-22","2026-03-19","2025-10-28","2024-07-22","2026-01-19","2026-01-19","2026-01-19","2024-10-15","2024-10-10","2026-03-02","2025-04-14","2024-10-21","2024-10-21","2025-01-20","2024-09-04","2025-03-03","2025-03-03","2026-03-13","2026-03-02","2025-09-05","2025-09-05","2024-12-25","2025-07-02","2024-05-13","2025-01-20","2026-03-13","2025-05-28","2024-12-28","2024-01-29","2025-06-10","2026-03-19","2026-02-16","2024-05-01","2024-05-01","2024-05-01","2025-04-28","2025-03-13","2025-12-16","2024-12-03","2024-12-28","2024-12-28","2025-02-04","2025-03-31","2025-04-29","2024-01-03","2026-03-02","2025-11-10","2025-11-10","2025-03-31","2025-03-31","2025-12-16","2024-05-01","2024-08-16","2025-12-16","2025-12-16","2025-12-03","2024-12-25","2024-08-13","2024-10-24","2024-10-24","2023-12-12","2024-12-28","2024-08-27"],"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":[["","","Ciclopirox","80 MG","","Select","Select",""],["","","Methimazole","10 MG","","Select","Select",""],["","","1.5 Ml Fremanezumab-Vfrm","150 MG","","Select","Select",""],["","","Fluoxetine","40 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Carisoprodol","350 MG","","Select","Select",""],["","","Acetaminophen-Cod #3 Tablet","","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Hydrochlorothiazide","25 MG","","Select","Select",""],["","","Meloxicam","15 MG","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Moxifloxacin","400 MG","","Select","Select",""],["","","Atorvastatin","40 MG","","Select","Select",""],["","","Meclizine Hydrochloride","25 MG","","Select","Select",""],["","","Humira Cf Pen","40 MG","","Select","Select",""],["","","Sucralfate","1 GM","","Select","Select",""],["","","Prochlorperazine","5 MG","","Select","Select",""],["","","Cholestyramine Resin","4000 MG","","Select","Select",""],["","","Loperamide Hydrochloride","2 MG","","Select","Select",""],["","","Pantoprazole Sod Dr","40 MG","","Select","Select",""],["","","Propranolol Hydrochloride","20 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Topiramate","100 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Clopidogrel","75 MG","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Qulipta","60 MG","","Select","Select",""],["","","Clindamycin","300 MG","","Select","Select",""],["","","Ubrelvy","100 MG","","Select","Select",""],["","","Colchicine","0.6 MG","","Select","Select",""],["","","Hydralazine Hydrochloride","50 MG","","Select","Select",""],["","","Breo Ellipta 100-25 Mcg Inhalr","","","Select","Select",""],["","","Ofloxacin","3 MG","","Select","Select",""],["","","Prednisolone Acetate","","","Select","Select",""],["","","Cyclopentolate Hydrochloride","10 MG","","Select","Select",""],["","","Humira Pen","","","Select","Select",""],["","","Leflunomide","20 MG","","Select","Select",""],["","","Megestrol Acetate","","","Select","Select",""],["","","Acetaminophen\/Codeine","","","Select","Select",""],["","","Breztri Aerosphere","","","Select","Select",""],["","","Levothyroxine Sodium","0.112 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Aripiprazole","5 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","24 Hr Guanfacine","3 MG","","Select","Select",""],["","","Cefuroxime","500 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Lagevrio","200 MG","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Dexamethasone","1 MG","","Select","Select",""],["","","Oxybutynin Chloride","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":""}]}]}