{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara Loggins","gend":1,"currentgend":"","add":"988 Cain Rd","city":"Dawsonville","state":"GA","zip":30534,"dob":"1966-11-05","age":"","mstatus":"","insh":"0009026649002","cliId":"","pno":6787761233,"cno":6787761233,"email":"","ename":"","eno":"","pphy":"Jennifer Anderson","ppno":7702975700,"pcpadd":"725 JESSE JEWELL PKWY SE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013834,"pcpcounty":"","pcpid":"","pcpname":"725 JESSE JEWELL PKWY SE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"988 Cain Rd","madd2":"","madd3":"","mcity":"Dawsonville","mstate":"GA","mzip":30534,"pcpfaxno":7702199000,"pcpnpi":1457748451,"currentgendcomment":"","pphycomment":"","uniqueid":456153,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z17.0","Z17.21","Z17.32","H25.13","M25.511","M25.611","C50.211","C77.3","Z68.31","Z79.810","M81.0","R92.8","M79.7","Z78.0","Z17.411","Z90.11","C50.911","H26.9","C50.919","E78.00","F41.9","E78.5","M79.10","N39.41","M81.8","Z13.31","N39.46","Z71.83","Z12.11","Z12.12","S01.00X","R30.0","Z68.32","N92.4","N95.0","R92.1","E78.49","H25.813","N60.12","Z68.30","Z01.419","N84.0","Z85.3","N60.21","H25.12","H26.491","H25.11","Z01.818","C50.212","N60.92","N60.11"],"date":["2026-01-02","2025-05-30","2025-05-30","2025-03-24","2025-12-29","2025-12-29","2026-01-02","2025-09-04","2025-12-19","2025-12-15","2025-12-15","2025-12-15","2025-12-15","2025-04-24","2025-05-30","2025-05-12","2025-12-10","2025-11-12","2025-11-12","2025-11-12","2025-11-12","2025-09-17","2025-09-17","2025-09-17","2025-12-19","2025-08-29","2025-03-14","2025-03-14","2025-08-18","2025-08-18","2025-07-11","2025-12-31","2025-12-31","2025-05-08","2025-05-14","2025-02-18","2025-12-19","2025-01-14","2025-01-30","2025-02-10","2025-04-24","2025-05-14","2025-06-25","2025-02-18","2025-11-12","2025-11-06","2025-04-16","2025-02-13","2025-12-10","2025-01-30","2025-01-30"],"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":[["","","Ivermectin","3 MG","","Select","Select",""],["","","Lovastatin","40 MG","","Select","Select",""],["","","Cyclopentolate Hydrochloride","10 MG","","Select","Select",""],["","","Prednisolone Acetate","10 MG","","Select","Select",""],["","","Bromfenac","0.9 MG","","Select","Select",""],["","","Moxifloxacin","5 MG","","Select","Select",""],["","","Duloxetine","30 MG","","Select","Select",""],["","","Montelukast","10 MG","","Select","Select",""],["","","Tamoxifen Citrate","","","Select","Select",""],["","","Cefadroxil","500 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Oxybutynin Chloride","5 MG","","Select","Select",""],["","","Ezetimibe","10 MG","","Select","Select",""],["","","Prednisone","5 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Dexamethasone","2 MG","","Select","Select",""],["","","Alendronic Acid","70 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":""}]}]}