{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dana Miller","gend":1,"currentgend":"","add":"2858 Village Ct","city":"Gainesville","state":"GA","zip":30506,"dob":"1963-03-06","age":"","mstatus":"","insh":"0009022808001","cliId":"","pno":7706542143,"cno":"","email":"dannamiller2@att.net","ename":"","eno":"","pphy":"Soha Taheri","ppno":8086913000,"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":"2858 Village Ct","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30506,"pcpfaxno":"","pcpnpi":1487849378,"currentgendcomment":"","pphycomment":"","uniqueid":207937,"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":["E43","Z66","D70.1","E87.4","I10","F32.A","D64.9","E87.1","Z85.3","K21.9","F41.9","E86.1","T45.1X5","E87.6","Z79.811","K21.00","Z79.899","F32.9","F43.22","K44.9","Z87.11","Z92.3","R53.1","F33.1","C50.411","Z17.0","L89.899","I73.9","Z68.1","F17.200","R29.6","Z90.49","Z88.1","Z88.0","F33.41","R92.30","K52.9","K76.9","F17.210","K51.00","D70.2","F10.90","E44.0","F39","R11.2","Z87.891","Z17.22","Z17.32","Z90.11","Z80.3","Z72.0","E86.0","R92.2","R53.2","R42","D05.11","R59.0","Z51.11","T78.40X","R11.0","D72.818","E83.42","Z76.89","L30.9","Z13.31","Z68.20","D70.9","R50.81","R00.0","I21.9","Z45.2","R62.7","I44.4","Z71.89","K63.89"],"date":["2026-01-20","2025-03-28","2025-05-07","2025-03-28","2026-01-22","2025-03-28","2025-05-07","2026-03-03","2025-03-28","2026-01-20","2025-03-28","2025-03-28","2025-05-07","2026-03-03","2026-01-20","2025-04-02","2026-01-20","2026-01-20","2026-03-03","2025-03-28","2025-03-28","2026-01-20","2026-01-22","2026-01-22","2026-03-03","2026-03-03","2026-01-20","2026-01-20","2026-03-03","2026-01-20","2026-01-20","2026-01-20","2026-01-20","2026-01-20","2025-10-01","2025-09-08","2025-09-04","2025-10-01","2025-10-01","2025-04-02","2025-04-02","2025-04-02","2025-04-02","2025-04-02","2025-04-02","2025-05-07","2025-06-04","2025-06-04","2025-03-05","2025-04-03","2025-03-04","2025-10-01","2025-09-08","2025-03-25","2025-03-25","2025-01-13","2025-01-13","2025-05-07","2025-05-07","2025-05-07","2025-03-28","2025-10-01","2026-03-03","2026-03-03","2025-04-03","2025-05-28","2025-03-28","2025-03-28","2025-03-24","2025-03-25","2025-07-09","2026-01-20","2025-03-24","2025-03-18","2025-03-24"],"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":[["","","Diclofenac Sodium","75 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Tramadol Hydrochloride","50 MG","","Select","Select",""],["","","Metronidazole","500 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","Select","Select",""],["","","Hydroxyzine Pamoate","","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Levofloxacin","750 MG","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Sertraline","50 MG","","Select","Select",""],["","","Fluoxetine","20 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":""}]}]}