{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Frank Koger","gend":0,"currentgend":"","add":"443 Madison St","city":"Grovetown","state":"GA","zip":30813,"dob":"1962-01-31","age":"","mstatus":"","insh":"0009022412001","cliId":"","pno":7068559438,"cno":7068559438,"email":"kogergrovetown@aol.com","ename":"","eno":"","pphy":"Ermina Mujadzic","ppno":7068542222,"pcpadd":"925 BRANCH CT STE 101","pcpcity":"GROVETOWN","pcpstate":"GA","pcpzip":30813,"pcpcounty":"","pcpid":"","pcpname":"925 BRANCH CT STE 101","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"443 Madison St","madd2":"","madd3":"","mcity":"Grovetown","mstate":"GA","mzip":30813,"pcpfaxno":7068542223,"pcpnpi":1588790794,"currentgendcomment":"","pphycomment":"","uniqueid":450311,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D48.5","D18.01","I87.2","D22.9","D22.5","L82.1","Z85.820","M95.2","G47.33","D62","E11.52","C43.9","C61","D75.838","E03.9","E11.40","E11.65","E55.9","F32.A","I10","I16.0","I25.10","N40.0","Z79.82","Z79.84","Z85.46","Z90.49","Z95.5","S01.402","E66.9","Z98.890","Z79.85","Z68.45","R42","F41.1","M17.12","M47.812","C43.62","I12.9","N18.9","E07.9","G47.30","I87.8","Z88.6","Z91.030","D03.39","C43.72","L57.0","L90.5","Z86.006","I25.118","I25.83","H90.3","H69.82","G31.84","G60.3","E53.8","M54.16","R94.01","E11.42","R26.89","S00.83X","L76.32","N18.30","E11.22","L03.90","D75.839","N20.0","E86.0","K57.30","M47.816","M43.16","D72.829","R79.89","E83.51","R10.30","R11.2","M54.50","R19.7","M79.604","T81.9XX","R55","Z01.818","F33.1","F41.9","F43.29","I96","M17.11","M25.562","G89.29","R41.89","L76.22","M17.0","Z94.5","Z87.828","E78.2","I49.1","I20.0","D49.2","R07.9","D03.72","U07.1","R52","Z03.89","I67.82","M54.2","R53.1","K52.9","R10.84","M62.830","R07.89","T86.821","L98.8"],"date":["2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-09-24","2025-02-27","2025-09-24","2025-04-23","2025-08-28","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-04-08","2025-05-07","2025-11-17","2025-04-08","2025-04-08","2026-02-03","2025-04-08","2025-05-07","2025-04-08","2025-05-07","2025-05-07","2025-06-26","2025-11-17","2025-05-07","2025-05-07","2025-05-07","2025-09-24","2025-05-07","2025-05-07","2025-01-20","2025-10-29","2025-12-03","2025-12-20","2025-11-03","2025-12-20","2025-06-26","2025-06-26","2025-06-26","2025-06-26","2025-06-26","2025-06-26","2025-04-02","2026-01-07","2025-09-24","2025-09-24","2025-09-24","2025-02-14","2025-02-14","2025-04-17","2025-08-28","2025-09-08","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2025-08-13","2025-04-10","2025-04-10","2025-12-20","2025-12-20","2025-04-10","2025-04-10","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-04-08","2025-02-01","2025-04-08","2025-04-09","2025-04-09","2025-04-09","2025-04-21","2025-12-03","2025-12-03","2025-12-03","2025-08-27","2025-04-08","2026-03-04","2025-05-21","2025-05-21","2025-01-14","2025-01-14","2025-01-14","2025-09-24","2025-02-14","2025-05-23","2026-02-03","2026-02-03","2025-07-01","2025-11-17","2025-12-20","2025-12-20","2025-11-17","2025-11-17","2025-12-20","2025-01-20","2025-04-09","2025-11-04"],"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":[["","","Amoxicillin","875 MG","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Metformin Hydrochloride","1000 MG","","Select","Select",""],["","","Armodafinil","150 MG","","Select","Select",""],["","","Losartan Potassium","50 MG","","Select","Select",""],["","","Ozempic","","","Select","Select",""],["","","Flublok 2025-2026","","","Select","Select",""],["","","Fluorouracil","","","Select","Select",""],["","","Calcipotriene","0.05 MG","","Select","Select",""],["","","Ergocalciferol","1.25 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Metoclopramide Hydrochloride","","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Dicyclomine Hydrochloride","","","Select","Select",""],["","","Spironolactone","25 MG","","Select","Select",""],["","","Hydroxyzine Hydrochloride","25 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 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":""}]}]}