{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"El S Thomas","gend":0,"currentgend":"","add":"701 Old Statenville Rd","city":"Valdosta","state":"GA","zip":31601,"dob":"1963-12-10","age":"","mstatus":"","insh":"0007247157001","cliId":"","pno":2295633631,"cno":"","email":"victoria188thomasine@yahoo.com","ename":"","eno":"","pphy":"JIANFENG WANG","ppno":6174923500,"pcpadd":"2501 N PATTERSON ST","pcpcity":"VALDOSTA","pcpstate":"GA","pcpzip":31602,"pcpcounty":"","pcpid":"","pcpname":"2501 N PATTERSON ST","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"701 Old Statenville Rd","madd2":"","madd3":"","mcity":"Valdosta","mstate":"GA","mzip":31601,"pcpfaxno":"","pcpnpi":1922395664,"currentgendcomment":"","pphycomment":"","uniqueid":408522,"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":["I10","E78.5","Z79.899","Z85.46","Z96.651","R07.1","Z79.891","I26.99","I25.2","M79.10","R68.83","J02.9","G47.00","M19.012","F52.21","E55.9","R51.9","S09.90X","J06.9","Z86.711","G89.29","T22.112","R68.89","Z53.21","Z79.01","Z13.29","Z12.5","J20.9","Z20.822","Z01.818","K40.90","J11.1","J40","N40.0","S01.01X","Z23","M25.531","M79.641","G89.11","R22.43","K40.91","M79.652","S79.922","M25.552","S79.912","I82.409","Z20.2","R10.84","R22.31","T63.301","L03.313","Z85.9","R06.02","R07.9","S49.91X","M25.511","I82.412","I82.432","S69.81X","R03.0","W18.39X","Y92.414","S29.9XX","S39.91X","S39.93X","S69.91X","I82.4Y2","D64.9","Z80.3","R31.29","R35.0","N30.00","M25.562","R94.31","R05.9","R07.0","M51.26","M47.816","N28.1","Z98.890","S70.12X","R19.8","R06.89","L73.1","D68.69","S63.91X","M19.90","S89.92X","M17.12","S05.01X"],"date":["2026-01-27","2026-01-27","2026-01-27","2025-08-18","2026-01-27","2024-05-31","2025-08-05","2024-09-24","2024-07-23","2024-04-20","2024-04-20","2024-04-20","2026-01-20","2026-01-20","2026-01-20","2026-01-20","2025-10-10","2025-10-10","2025-05-13","2025-05-13","2025-05-13","2024-05-18","2026-01-02","2025-08-04","2024-09-24","2024-06-03","2025-07-22","2024-01-02","2024-01-02","2025-08-13","2026-02-25","2024-04-19","2025-05-12","2025-08-05","2025-10-10","2025-10-10","2024-08-08","2024-08-08","2024-08-08","2024-07-26","2025-08-05","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2024-10-21","2026-01-27","2026-02-20","2024-08-08","2024-03-16","2024-03-16","2024-03-16","2024-05-31","2024-05-31","2024-05-31","2024-06-03","2024-09-24","2024-07-23","2024-08-08","2024-08-08","2024-08-08","2024-08-08","2024-10-02","2024-10-02","2024-10-02","2024-08-08","2024-07-25","2024-09-24","2024-09-24","2025-02-05","2025-02-05","2025-02-05","2025-02-09","2024-08-08","2024-04-19","2024-04-19","2026-01-02","2026-01-02","2026-02-20","2026-02-20","2024-07-22","2024-07-24","2024-07-24","2024-03-16","2024-08-12","2024-08-08","2026-01-27","2025-02-09","2025-02-09","2024-04-24"],"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":[["","","Amlodipine","10 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Fluticasone Propionate","0.05 MG","","Select","Select",""],["","","Hydrochlorothiazide","25 MG","","Select","Select",""],["","","Celecoxib","200 MG","","Select","Select",""],["","","Trazodone Hydrochloride","50 MG","","Select","Select",""],["","","Meloxicam","7.5 MG","","Select","Select",""],["","","Erythromycin","0.005 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Methocarbamol","750 MG","","Select","Select",""],["","","Tramadol Hcl","50 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Eliquis Dvt-Pe Treat Start","5 MG","","Select","Select",""],["","","Eliquis","5 MG","","Select","Select",""],["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Ketorolac Tromethamine","10 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Benzonatate","100 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Silver Sulfadiazine","10 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 5-325 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":""}]}]}