{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James Harrelson","gend":0,"currentgend":"","add":"109 Inverness Dr","city":"Perry","state":"GA","zip":31069,"dob":"1963-11-29","age":"","mstatus":"","insh":"0009021600001","cliId":"","pno":4783189208,"cno":"","email":"","ename":"","eno":"","pphy":"Rachel Youngblood","ppno":4786331458,"pcpadd":"840 PINE ST STE 750","pcpcity":"MACON","pcpstate":"GA","pcpzip":31201,"pcpcounty":"","pcpid":"","pcpname":"840 PINE ST STE 750","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"109 Inverness Dr","madd2":"","madd3":"","mcity":"Perry","mstate":"GA","mzip":31069,"pcpfaxno":4786335025,"pcpnpi":1033405477,"currentgendcomment":"","pphycomment":"","uniqueid":447957,"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":["J69.0","E44.0","C01","E11.9","I10","K94.23","Z68.1","J98.8","F17.210","Z92.3","Z92.21","E83.52","R13.13","K59.00","R06.03","Z93.0","C32.1","R13.10","R63.4","Z93.1","E78.00","Z23","Z12.5","R73.03","Z43.1","B97.7","J96.21","J45.20","E78.5","Z79.891","C32.9","R06.1","F17.200","R09.3","I12.9","E78.2","Z79.899","J43.9","Z85.21","Z12.11","R91.8","C02.9","Z72.0","I89.0","J85.1","J93.9","J44.9","Z00.00","E78.1","J96.01","J96.11","C32.8","J96.00","Z09","Q31.5","R06.02","Z46.82","J95.811","K94.20","T17.900","K14.8","Z45.2","J18.9","R91.1","R06.00","L92.8"],"date":["2025-05-28","2025-05-20","2025-05-28","2025-07-23","2025-08-26","2025-05-20","2025-05-20","2025-05-20","2025-11-18","2025-05-20","2025-05-20","2025-05-20","2025-07-30","2025-05-20","2025-05-21","2026-03-18","2026-03-18","2026-03-03","2026-03-03","2026-03-03","2025-08-26","2025-08-26","2025-08-26","2026-02-24","2025-07-23","2025-07-23","2025-07-23","2025-07-23","2025-07-23","2025-07-23","2025-06-02","2025-05-28","2025-05-21","2025-07-02","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2026-02-24","2025-11-18","2025-06-02","2025-08-25","2025-03-05","2025-05-06","2025-06-10","2025-06-10","2025-11-17","2025-02-25","2025-05-28","2025-05-28","2025-05-28","2025-05-20","2025-06-02","2025-06-02","2025-05-20","2025-11-15","2025-06-10","2025-11-15","2025-01-30","2025-01-30","2026-02-23","2025-05-06","2025-10-20","2025-05-20","2026-03-18"],"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":[["","","Fenofibrate","200 MG","","Select","Select",""],["","","Atorvastatin","10 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Lansoprazole","15 MG","","Select","Select",""],["","","Amoxicillin\/Clavulanate Potassium","","","Select","Select",""],["","","Tobramycin\/Dexamethasone","","","Select","Select",""],["","","Dexamethasone","","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Triamcinolone Acetonide","1 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":""}]}]}