{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Luis Marenco","gend":0,"currentgend":"","add":"808 Stewart St","city":"Carrollton","state":"GA","zip":"30117","dob":"1973-07-20","age":"","mstatus":"","insh":"0009020443002","cliId":"","pno":"7065919351","cno":"7065919351","email":"","ename":"","eno":"","pphy":"Pradeep Chaganti","ppno":"7062783431","pcpadd":"705 DIXIE ST","pcpcity":"CARROLLTON","pcpstate":"GA","pcpzip":"30117","pcpcounty":"","pcpid":"","pcpname":"705 DIXIE ST","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"808 Stewart St","madd2":"","madd3":"","mcity":"Carrollton","mstate":"GA","mzip":"30117","pcpfaxno":"","pcpnpi":"1255680575","currentgendcomment":"","pphycomment":"","uniqueid":"446885","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":["C71.9","I10","G40.909","R13.10","L89.150","N30.00","R74.01","R51.9","K75.81","E11.9","J12.3","R29.898","E43","G93.41","J96.01","Z68.1","R47.01","E11.65","R13.12","Z66","Z79.4","R06.02","R20.2","R78.81","Z09","R63.0","Z74.1","B96.20","Z68.21","E87.8","R53.1","G93.40","A41.9","R63.4","E87.6","Z79.52","R40.20","R00.0","R40.243","Z11.52","G23.8","J69.0","G93.6","N30.01","C71.0","Z16.23","Z79.84","J18.9","R79.89","R94.2","R52","R05.9","G91.4","R56.9","N39.0","D63.0","H53.2","G81.91","K21.9","D50.8","E78.2","R53.82","R16.0","R26.81","Z92.3","Z55.6","Z91.81","R30.0","B96.29","R63.6","Z68.20","Z16.24","Z87.01","Z99.3","Z79.899","R09.02","D64.9","R91.8","G93.89","R41.82","R29.818","R53.83","R79.1"],"date":["2026-08-19","2026-07-04","2026-07-04","2026-06-30","2026-07-04","2026-06-30","2026-06-30","2026-04-24","2026-06-30","2026-06-30","2026-05-02","2026-08-19","2026-07-04","2026-07-04","2026-07-04","2026-07-04","2026-07-04","2026-07-04","2026-07-14","2026-07-04","2026-07-04","2026-07-14","2026-06-30","2026-02-23","2026-06-24","2026-02-23","2026-02-23","2026-02-23","2026-04-21","2026-04-22","2026-07-14","2026-08-05","2026-02-05","2026-06-30","2026-06-24","2026-06-30","2026-04-24","2026-06-30","2026-04-24","2026-04-24","2026-04-24","2026-07-03","2026-02-05","2026-02-05","2026-02-05","2026-02-05","2026-02-05","2026-04-28","2026-04-28","2026-04-21","2026-02-06","2026-04-28","2026-01-21","2026-07-03","2026-01-21","2026-01-21","2026-01-21","2026-01-21","2026-06-30","2026-01-21","2026-06-30","2026-01-21","2026-01-21","2026-01-21","2026-01-21","2026-01-21","2026-06-30","2026-05-28","2026-06-30","2026-06-30","2026-06-30","2026-06-30","2026-06-30","2026-06-30","2026-06-30","2026-07-03","2026-04-29","2026-07-10","2026-06-18","2026-06-18","2026-06-18","2026-06-18","2026-04-28"],"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":[["","","AZITHROMYCIN","200000 MG\/5ML","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100000 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","108000 MCG\/ACT","","Select","Select",""],["","","DEXAMETHASONE","4000 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","0","","Select","Select",""],["","","AMLODIPINE BESYLATE","5000 MG","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","5000 MG","","Select","Select",""],["","","CEPHALEXIN","500000 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","0","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","20000 MG","","Select","Select",""],["","","FOSFOMYCIN TROMETHAMINE","3000 GM","","Select","Select",""],["","","VALTOCO","10000 MG\/0.1ML","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","0","","Select","Select",""],["","","CYPROHEPTADINE HYDROCHLORIDE","4000 MG","","Select","Select",""],["","","LEVETIRACETAM","100000 MG\/ML","","Select","Select",""],["","","CEFDINIR","300000 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE","20000 %","","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":""}]}]}