{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert Register","gend":0,"currentgend":"","add":"502 Ruff Rd","city":"Rockmart","state":"GA","zip":30153,"dob":"1969-12-23","age":"","mstatus":"","insh":"0009021694001","cliId":"","pno":6784889916,"cno":"","email":"unitedmetalcraft.rr@gmail.com","ename":"","eno":"","pphy":"Shashank Nuguru","ppno":3179481310,"pcpadd":"120 STONEBRIDGE PKWY STE 320","pcpcity":"WOODSTOCK","pcpstate":"GA","pcpzip":30189,"pcpcounty":"","pcpid":"","pcpname":"120 STONEBRIDGE PKWY STE 320","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"502 Ruff Rd","madd2":"","madd3":"","mcity":"Rockmart","mstate":"GA","mzip":30153,"pcpfaxno":3179480503,"pcpnpi":1285987552,"currentgendcomment":"","pphycomment":"","uniqueid":448179,"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":["I10","E66.811","E03.9","Z13.89","E66.09","E78.2","Z68.30","N18.2","I48.0","Z98.890","Z12.11","Z12.12","R97.20","R03.0","D49.2","L57.0","L57.8","L81.4","L82.1","D22.5","L98.5","C44.529","R91.1","I82.531","J10.1","D22.9","L72.9","Z79.01","Z79.899","K63.5","K57.30","R19.5","R00.1","I44.0","I48.19","E78.5","D23.9","R11.0","I48.3","I48.4","Z51.81","E78.00","Z68.31"],"date":["2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2026-03-09","2025-07-21","2025-06-11","2025-09-25","2026-03-12","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2025-03-05","2025-03-12","2026-03-12","2025-12-29","2025-02-12","2025-02-12","2025-10-15","2025-10-15","2025-07-21","2025-07-21","2025-07-21","2025-07-14","2025-07-14","2026-03-12","2026-03-12","2026-03-12","2025-07-03","2025-07-14","2025-07-14","2025-07-14","2025-02-04","2025-02-04"],"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":[["","","Levothyroxine Sodium","0.05 MG","","Select","Select",""],["","","Rosuvastatin Calcium","5 MG","","Select","Select",""],["","","Rivaroxaban","20 MG","","Select","Select",""],["","","Flecainide Acetate","50 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","{2","480 ML","","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":""}]}]}