{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carey A Crespo","gend":0,"currentgend":"","add":"1575 Johnson Rd","city":"Gainesville","state":"GA","zip":30504,"dob":"1966-03-22","age":"","mstatus":"","insh":"0007655420001","cliId":"","pno":4044881031,"cno":"","email":"ecsservicecalls@gmail.com","ename":"","eno":"","pphy":"","ppno":6173045697,"pcpadd":"500 W CUMMINGS PARK STE 2700","pcpcity":"WOBURN","pcpstate":"MA","pcpzip":"01801","pcpcounty":"","pcpid":"","pcpname":"500 W CUMMINGS PARK STE 2700","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1575 Johnson Rd","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30504,"pcpfaxno":"","pcpnpi":1548853096,"currentgendcomment":"","pphycomment":"","uniqueid":424155,"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":["S83.282","S83.8X2","M22.42","J96.01","S82.831","S27.0XX","S22.20X","T79.A22","S22.41X","S82.142","S82.892","I10","E66.9","M87.9","D62","T81.42X","T79.7XX","S93.411","S83.412","R40.241","S30.1XX","Z88.5","Z91.030","Z96.649","Z98.1","R07.9","Z01.810","Z01.812","J02.9","J22","R50.9","R05.1","Z72.0","Z68.29","T81.49X","S22.22X","F11.90","S82.891","S92.145","V87.7XX","M71.062","B95.2","R33.9","S82.131","M01.X62","G89.4","F41.9","G47.00","R79.89","R26.89","Z02.83","Z79.891","Z79.899","Z47.89","R55","M17.11","S82.61X","S82.842","S92.142","Z46.82","M19.072","Z01.818","S82.832","S92.111","S92.131","J98.4","M54.50","S83.262","M54.6","G89.29","Z87.81","G47.33","R03.0","Z68.32","S29.9XX","S39.93X","S09.90X","S19.9XX","M25.572","D23.72","M79.672","M21.612","Z68.35","Z79.1","B96.29","G89.18","S82.92X","Z74.01","S82.91X","M23.322","M94.262","Z00.00","T81.41X","L02.416","A49.8","B96.21","J98.2","S82.101","F11.10","M25.512","M25.562","R56.9","M12.562","S22.39X","R00.0","Z98.890","J44.9","G89.11","R10.9","V89.2XX","S83.242","S39.91X","M47.814","M47.816","M25.551","M25.552","M46.1","M79.18","E66.01","J98.11","M86.469","D63.8","R63.8","T84.84X","M17.32","S83.195","S92.121","S82.152","S92.415","E44.0","I45.10","S82.851","Z13.6","Z68.30","S82.401","J90","J84.9","S82.141","M51.26","M47.817","M21.622","M12.812","L84","S93.04X","S92.152","L76.32","E43","T07.XXX","V89.0XX","Z74.3","I49.9","S92.112","N20.0","M51.24","M51.34","I77.810","Z12.11","Z12.12","M75.112","M24.112","M19.012","R91.8","R09.89"],"date":["2025-05-20","2025-01-14","2025-01-14","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2026-01-19","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-06-20","2025-04-08","2024-12-30","2024-12-30","2025-11-05","2025-11-05","2025-11-05","2025-11-05","2026-01-19","2025-12-09","2025-04-30","2025-05-20","2025-05-16","2025-12-02","2025-12-02","2025-06-17","2025-05-16","2025-05-20","2025-05-05","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-08-22","2025-05-20","2025-05-20","2025-07-30","2025-03-28","2025-03-28","2025-03-28","2025-05-02","2025-03-29","2025-03-28","2025-12-18","2025-03-28","2025-03-28","2025-03-28","2025-03-28","2025-07-05","2025-04-04","2025-07-18","2025-07-18","2025-12-18","2025-12-18","2026-01-19","2026-01-19","2025-03-26","2025-03-26","2025-03-26","2025-03-26","2024-11-08","2024-11-08","2024-11-08","2024-11-08","2024-12-04","2025-08-22","2025-04-30","2025-12-22","2025-05-20","2025-05-20","2025-05-20","2024-10-30","2024-12-04","2024-08-22","2025-04-30","2025-06-17","2025-09-30","2025-05-01","2025-03-26","2025-03-26","2025-04-11","2024-10-22","2026-01-19","2025-09-17","2026-01-19","2025-03-26","2025-03-26","2026-01-19","2026-01-19","2025-06-11","2025-06-11","2025-03-27","2025-01-14","2025-03-26","2025-07-05","2025-06-11","2025-06-11","2025-06-11","2025-06-11","2025-06-11","2024-09-24","2025-04-08","2025-09-30","2025-07-17","2025-07-22","2025-12-22","2025-12-22","2025-04-29","2025-03-26","2025-03-26","2025-05-15","2025-05-15","2025-03-26","2025-04-25","2025-06-30","2025-06-30","2025-04-02","2025-03-27","2025-03-27","2025-03-26","2025-07-05","2025-07-05","2024-10-22","2024-11-26","2024-10-22","2025-05-16","2025-04-10","2025-04-30","2025-05-16","2025-03-26","2025-03-26","2025-03-26","2025-04-25","2025-04-28","2024-10-08","2025-07-05","2025-07-05","2025-07-22","2025-06-20","2025-06-20","2024-12-07","2024-12-07","2024-12-07","2025-03-29","2025-03-29"],"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":[["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Buspirone Hcl","","","Select","Select",""],["","","Tamsulosin Hydrochloride","0.4 MG","","Select","Select",""],["","","Pantoprazole Sodium","","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Trazodone Hydrochloride","100 MG","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Diazepam","","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Oxycodone\/Acetaminophen","","","Select","Select",""],["","","Minocycline","100 MG","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","{11 Varenicline","0.5 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":""}]}]}