{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Misty Mcintyre","gend":1,"currentgend":"","add":"809 Sims Harris Rd","city":"Gillsville","state":"GA","zip":30543,"dob":"1977-05-13","age":"","mstatus":"","insh":"0008176942001","cliId":"","pno":7623099005,"cno":"","email":"mistymcintyre77@gmail.com","ename":"","eno":"","pphy":"Jeffrey Thomas","ppno":7063562934,"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":"809 Sims Harris Rd","madd2":"","madd3":"","mcity":"Gillsville","mstate":"GA","mzip":30543,"pcpfaxno":7063568037,"pcpnpi":1811935778,"currentgendcomment":"","pphycomment":"","uniqueid":439671,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C21.0","Z93.3","K59.01","R32","Z63.4","R82.998","K59.00","C21.1","D50.9","Z87.891","G89.3","K61.0","D61.810","Z11.52","R65.21","E87.21","E87.1","D64.9","D84.9","N30.90","E86.0","E87.6","F12.90","F17.210","F99","M54.9","K62.89","E83.42","T45.1X5","Z92.3","F17.290","Z51.11","F41.9","K60.30","R39.81","Z79.899","I95.89","Z01.89","C44.520","D61.818","A41.9","R65.20","H25.13","H52.03","H52.221","Z13.5","K62.6","Z12.11","K64.5","Z87.19","C26.9","C20","R11.0","N30.00","R10.9","R93.5","Z51.5","G89.4","R11.2","G47.00","L03.315","R10.84","F32.0","F41.1","A63.0","D49.2","I95.9","D70.9","S31.839","I34.0"],"date":["2025-09-23","2026-02-25","2025-07-03","2025-07-03","2025-07-03","2026-02-10","2026-02-10","2026-03-19","2026-03-17","2026-02-10","2026-03-17","2025-06-06","2025-09-23","2025-09-23","2025-09-23","2025-09-24","2025-09-23","2025-09-24","2025-09-23","2025-09-23","2025-09-23","2025-09-24","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2025-09-09","2026-03-17","2026-03-17","2026-03-17","2025-11-12","2025-11-12","2025-04-10","2025-09-23","2025-09-29","2025-09-29","2025-09-27","2026-02-13","2026-02-13","2026-02-13","2026-02-13","2025-06-05","2025-06-05","2025-06-05","2025-06-05","2025-09-23","2025-06-17","2025-09-09","2025-09-30","2025-09-23","2025-09-23","2026-03-11","2026-01-19","2025-09-23","2026-03-11","2025-05-15","2025-05-15","2025-05-15","2025-04-10","2025-04-10","2026-03-11","2025-09-24","2025-09-24","2025-09-24","2025-09-26"],"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":[["","","Ondansetron","8 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","10 MG","","Select","Select",""],["","","Lorazepam","0.5 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","Silver Sulfadiazine","10 MG","","Select","Select",""],["","","Gabapentin","100 MG","","Select","Select",""],["","","Sertraline Hydrochloride","","","Select","Select",""],["","","24 Hr Nicotine","0.583 MG","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Buspirone Hydrochloride","","","Select","Select",""],["","","Acetaminophen","300 MG","","Select","Select",""],["","","Hydrocortisone","25 MG","","Select","Select",""],["","","Ergocalciferol","1.25 MG","","Select","Select",""],["","","Lidocaine\/Prilocaine","","","Select","Select",""],["","","Midodrine Hydrochloride","5 MG","","Select","Select",""],["","","Amoxicillin","875 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":""}]}]}