{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lisa Welborn","gend":1,"currentgend":"","add":"104 Turk St","city":"Homer","state":"GA","zip":30547,"dob":"1972-11-18","age":"","mstatus":"","insh":"0007282047002","cliId":"","pno":7063624213,"cno":7063624213,"email":"","ename":"","eno":"","pphy":"Kuang Chang","ppno":7063532990,"pcpadd":"3320 OLD JEFFERSON RD BLDG 800","pcpcity":"ATHENS","pcpstate":"GA","pcpzip":30607,"pcpcounty":"","pcpid":"","pcpname":"3320 OLD JEFFERSON RD BLDG 800","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"104 Turk St","madd2":"","madd3":"","mcity":"Homer","mstate":"GA","mzip":30547,"pcpfaxno":7063532992,"pcpnpi":1952567505,"currentgendcomment":"","pphycomment":"","uniqueid":418627,"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":["M81.0","M85.89","C50.212","D50.8","D50.9","Z80.0","Z79.899","K64.8","K92.1","K63.9","M51.36","F41.8","J30.2","Z68.33","E78.2","G25.81","E53.8","K64.4","K44.9","D50.0","R53.83","E55.9","H90.5","H93.19","J30.9","J34.3","R49.0","R68.89","I10","K21.9","M79.672","Z13.31","Z13.89","Z68.26","N64.4","R19.7","Z85.3","Z98.82","M79.622","R06.09","G47.33","Z13.6","R06.02","R30.0","Z68.32","C44.219","H91.8X3","L23.9","L82.0","L53.8","L29.89","D48.5","R10.30","L08.9","N39.0","Z90.13","C44.292","R19.5","Z98.84","D12.8","Z98.890","C72.0","M85.80","Z98.86","K62.1"],"date":["2026-02-23","2024-03-20","2026-02-23","2026-02-23","2026-02-23","2026-02-23","2025-08-11","2024-11-13","2024-05-08","2024-05-09","2024-09-10","2025-12-15","2024-09-10","2024-09-10","2025-12-15","2025-12-15","2025-12-15","2024-11-13","2024-11-13","2024-09-10","2024-03-25","2025-12-15","2024-04-01","2024-04-01","2024-04-01","2024-04-01","2024-04-01","2024-04-01","2025-12-15","2025-12-15","2025-12-15","2025-12-15","2025-12-15","2025-12-15","2026-02-23","2024-11-13","2025-03-31","2025-03-31","2025-03-31","2024-05-06","2024-11-13","2024-05-01","2024-05-01","2025-06-17","2025-06-17","2025-08-27","2024-03-25","2025-07-10","2025-07-10","2025-07-10","2025-07-10","2025-07-10","2024-04-15","2025-06-05","2024-04-26","2025-03-31","2025-08-11","2024-11-13","2024-11-13","2024-11-13","2024-11-13","2024-08-19","2025-08-04","2025-02-10","2024-11-14"],"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":[["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Venlafaxine","75 MG","","Select","Select",""],["","","Vitamin B12","0.5 MG","","Select","Select",""],["","","Ropinirole","1 MG","","Select","Select",""],["","","Omeprazole Dr","20 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","24 Hr Oxybutynin Chloride","5 MG","","Select","Select",""],["","","Doxycycline Hyclate","","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Bacitracin 0.5 Unt\/Mg \/ Polymyxin B 10 Unt\/Mg Ophthalmic Ointment","","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Mupirocin","0.02 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":""}]}]}