{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gary Wayne Elmore","gend":0,"currentgend":"","add":"4935 Friendly Acres Dr","city":"Gainesville","state":"GA","zip":30506,"dob":"1961-08-19","age":"","mstatus":"","insh":"0009021461002","cliId":"","pno":8503873672,"cno":8503873672,"email":"","ename":"","eno":"","pphy":"April McDonald","ppno":7702199000,"pcpadd":"743 SPRING ST NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013715,"pcpcounty":"","pcpid":"","pcpname":"743 SPRING ST NE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"4935 Friendly Acres Dr","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30506,"pcpfaxno":"","pcpnpi":1275892440,"currentgendcomment":"","pphycomment":"","uniqueid":447768,"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":["R06.02","E11.9","E03.9","E78.00","G25.81","J98.4","M31.31","M45.6","R82.90","D51.9","I10","I25.42","E78.2","E66.811","Z00.00","Z13.89","Z12.11","Z13.31","E66.89","Z68.33","R73.03","D58.2","R93.89","M10.09","M32.19","M33.20","M05.79","R76.8","Z87.891","I25.10","Z95.5","K21.9","J96.01","I11.0","E03.8","E66.01","R06.00","Z68.34","Z12.12","R76.0","M15.9","E66.812","Z68.36","I36.1","M25.551","M25.561","M54.50","R91.1","D14.31","D14.32","Z12.5","Z01.818","H61.21","J30.1","J30.0","R09.81","Z68.35","I11.9","R06.09","D75.1","Z91.89"],"date":["2025-06-01","2026-02-10","2026-02-10","2026-01-30","2026-02-10","2025-05-01","2025-07-01","2025-07-01","2025-07-01","2026-02-10","2026-02-10","2026-02-10","2026-02-10","2026-01-30","2025-11-07","2025-11-07","2025-11-07","2025-11-07","2025-11-07","2025-11-07","2025-08-07","2025-08-07","2025-07-17","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-05-01","2025-05-19","2025-05-01","2025-05-01","2025-05-29","2025-06-01","2025-06-01","2025-06-01","2025-06-01","2025-10-07","2025-08-10","2025-07-17","2025-07-17","2025-04-29","2025-01-29","2025-05-19","2025-07-01","2025-07-01","2025-07-01","2025-05-01","2025-05-30","2025-05-30","2025-11-07","2025-04-29","2025-08-01","2025-01-22","2025-01-22","2025-01-22","2025-03-03","2025-04-29","2025-04-29","2025-04-29","2025-04-29"],"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":[["","","Fluticasone Propionate","0.05 MG","","Select","Select",""],["","","Esomeprazole","40 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.088 MG","","Select","Select",""],["","","Breyna","","","Select","Select",""],["","","Losartan Potassium","100 MG","","Select","Select",""],["","","Clopidogrel","75 MG","","Select","Select",""],["","","Pramipexole Dihydrochloride","1 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","Carvedilol","12.5 MG","","Select","Select",""],["","","Mounjaro","","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","Cyanocobalamin","","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Chlorthalidone","25 MG","","Select","Select",""],["","","Flucelvax 2025-2026","","","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":""}]}]}