{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Danielle Lord","gend":1,"currentgend":"","add":"7338 Berry Hill Dr","city":"Gainesville","state":"GA","zip":30507,"dob":"1988-05-29","age":"","mstatus":"","insh":"0008072403001","cliId":"","pno":7705390775,"cno":"","email":"danid529@gmail.com","ename":"","eno":"","pphy":"James Hamilton","ppno":7702199630,"pcpadd":"3931 MUNDY MILL RD STE C","pcpcity":"OAKWOOD","pcpstate":"GA","pcpzip":30566,"pcpcounty":"","pcpid":"","pcpname":"3931 MUNDY MILL RD STE C","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"7338 Berry Hill Dr","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30507,"pcpfaxno":"","pcpnpi":1679986525,"currentgendcomment":"","pphycomment":"","uniqueid":427939,"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":["Z30.46","Z32.02","N93.8","R03.0","Z68.44","M53.3","J96.22","E11.69","E66.2","G89.29","Z90.721","E66.01","R53.82","N83.201","J96.21","E11.9","D27.0","Z99.81","J96.10","R10.84","J40","J96.01","N99.4","M79.89","Z00.01","R60.0","F33.1","F41.9","E66.9","E34.9","I34.0","I36.1","R06.02","F11.23","R40.0","Z68.45","J96.11","J96.12","R09.02","C56.1","L73.2","Z13.79","Z78.9","N30.00","C73","E04.2","E06.3","H60.63","K14.0","I10","R39.89","N83.291","M62.838","F32.A","G89.18","R91.8","R06.89","Z01.419","Z30.011","D39.11","Z68.43","R10.2","E04.1","Z98.890","Z90.89","R30.0","N83.8","D49.59","C56.9","R53.83","D27.9","K92.1","N93.9","K59.00","R14.2","B37.0","D49.7","Z01.818","Z00.00","E55.9","R73.03","Z76.89","R06.83","R11.2","T75.3XX","K52.9","M54.59","J81.1","R09.89","R07.9"],"date":["2024-07-31","2024-07-31","2024-07-31","2024-07-31","2026-03-13","2025-03-12","2025-10-05","2026-02-25","2026-03-19","2025-10-22","2025-09-09","2026-03-19","2024-06-12","2025-07-24","2025-10-05","2025-10-22","2025-10-05","2025-10-05","2026-03-08","2026-03-13","2026-03-09","2026-03-09","2025-07-24","2025-07-24","2025-10-22","2025-10-22","2026-02-25","2026-02-04","2025-10-22","2025-07-09","2025-10-05","2025-10-05","2025-10-05","2026-02-25","2025-01-15","2025-07-02","2026-03-19","2026-03-19","2025-10-04","2026-02-25","2025-05-05","2025-05-05","2025-05-05","2025-07-02","2025-10-02","2025-10-02","2025-10-02","2025-03-12","2025-03-12","2025-03-12","2025-07-02","2025-07-24","2026-02-25","2026-02-25","2025-07-24","2025-10-04","2025-10-04","2024-06-19","2024-06-19","2025-08-20","2024-07-24","2025-07-06","2025-10-05","2025-10-14","2025-10-14","2025-07-05","2025-07-05","2025-10-05","2025-10-05","2025-09-02","2026-02-04","2026-03-13","2025-10-05","2026-03-13","2026-03-13","2025-01-15","2025-10-02","2025-07-21","2024-07-24","2024-07-24","2024-07-24","2024-06-12","2024-06-12","2024-06-12","2024-06-12","2025-11-12","2025-03-12","2025-09-09","2025-09-09","2025-09-09"],"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":[["","","Cefdinir","300 MG","","Select","Select",""],["","","Buprenorphine","8 MG","","Select","Select",""],["","","Acetaminophen\/Codeine Phosphate","","","Select","Select",""],["","","Trazodone Hydrochloride","300 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.125 MG","","Select","Select",""],["","","Ibuprofen","600 MG","","Select","Select",""],["","","Potassium Chloride","20 MEQ","","Select","Select",""],["","","Diazepam","","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","24 Hr Bupropion Hydrochloride","300 MG","","Select","Select",""],["","","Nystatin 100000 Unt\/Ml Oral Suspension","","","Select","Select",""],["","","Mometasone Furoate","0.001 MG","","Select","Select",""],["","","Dexamethasone","","","Select","Select",""],["","","Mounjaro","","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","72 Hr Scopolamine","0.0139 MG","","Select","Select",""],["","","Tramadol Hydrochloride","100 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Albuterol Sulfate Hfa","","","Select","Select",""],["","","Fluoxetine","20 MG","","Select","Select",""],["","","Tizanidine","4 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","24 Hr Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Mupirocin","","","Select","Select",""],["","","Sulfamethoxazole","800 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":""}]}]}