{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary Jane Tuten","gend":1,"currentgend":"","add":"853 Willow Creek Dr","city":"Macon","state":"GA","zip":31204,"dob":"1963-06-16","age":"","mstatus":"","insh":"0007303580001","cliId":"","pno":4783180813,"cno":4783180813,"email":"janetuten@gmail.com","ename":"","eno":"","pphy":"Daryl Remick","ppno":4784050045,"pcpadd":"506 OSIGIAN BLVD","pcpcity":"WARNER ROBINS","pcpstate":"GA","pcpzip":31088,"pcpcounty":"","pcpid":"","pcpname":"506 OSIGIAN BLVD","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"853 Willow Creek Dr","madd2":"","madd3":"","mcity":"Macon","mstate":"GA","mzip":31204,"pcpfaxno":4784050054,"pcpnpi":1174956478,"currentgendcomment":"","pphycomment":"","uniqueid":304275,"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":["N80.319","K21.9","E03.9","N28.9","D25.9","Z79.82","Z79.899","D50.9","R10.13","K29.70","E78.2","K90.41","G47.9","E55.9","F41.9","J30.1","Z51.81","R31.9","K82.8","K63.1","Z00.00","N80.9","Z12.31","K57.30","R00.0","R53.83","R63.8","Z12.12","Z91.81","M17.12","Z01.818","Z01.810","R73.01","D50.8","J01.90","R51.9","R05.9","B96.89","Z20.828","Z01.411","N95.2","D64.9","R10.9","Z11.51","R00.2","Z09","G47.33","R06.83","G47.09","G47.63","R92.333","Z78.0","K57.92","N80.101","R68.89","K90.9","N95.9","F33.0","Z01.89","K56.699","Z01.812","R07.82","Z13.31","D75.839","Z78.9","R06.09","F50.89","J40","R09.89","Z13.820","Z12.11","D50.0","R10.10","Z79.02","M70.52","Z71.3","Z68.24","Z76.0","I21.09","R93.5"],"date":["2025-09-20","2025-09-20","2025-11-25","2025-09-20","2025-12-09","2025-09-20","2025-09-20","2026-02-04","2025-07-08","2025-07-08","2025-11-25","2025-05-20","2025-11-25","2025-11-25","2025-11-25","2025-11-25","2025-09-17","2025-11-25","2024-11-22","2025-09-05","2025-11-25","2025-12-09","2026-02-04","2025-09-08","2024-03-05","2024-03-05","2024-03-05","2024-10-22","2024-10-22","2025-08-01","2025-09-18","2025-09-17","2025-09-17","2025-09-17","2024-11-20","2024-11-20","2025-01-02","2024-11-20","2024-11-20","2025-12-09","2025-12-09","2025-12-09","2025-12-09","2025-12-09","2024-12-20","2024-12-18","2024-03-22","2024-03-22","2024-03-22","2024-03-22","2026-02-04","2024-10-21","2025-03-10","2025-09-19","2025-06-10","2025-02-04","2025-08-29","2025-08-29","2025-01-29","2025-09-10","2025-09-10","2024-12-12","2024-12-12","2024-12-12","2024-12-12","2025-01-28","2025-01-28","2025-01-02","2025-01-02","2024-10-21","2024-10-01","2025-09-10","2025-09-10","2025-09-10","2025-08-01","2024-03-26","2024-03-26","2024-03-26","2024-12-12","2025-09-19"],"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":[["","","Ezetimibe","10 MG","","Select","Select",""],["","","Spironolactone","100 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","150 MG","","Select","Select",""],["","","Temazepam","30 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.05 MG","","Select","Select",""],["","","Ketoconazole","20 MG","","Select","Select",""],["","","Rabeprazole Sodium","20 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Bromphen\/Pseudoephedrine Hcl\/Dextromethorphan Hbr","","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Estradiol","0.01 MG","","Select","Select",""],["","","Escitalopram","5 MG","","Select","Select",""],["","","Progesterone","200 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Paxlovid","","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Ondansetron","4 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":""}]}]}