{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kenneth Newsom","gend":0,"currentgend":"","add":"520 Saint Marlo Dr","city":"Centerville","state":"GA","zip":31028,"dob":"1975-02-26","age":"","mstatus":"","insh":"0009034486002","cliId":"","pno":6785165597,"cno":6785165597,"email":"","ename":"","eno":"","pphy":"Bradley Sumrall","ppno":4787437068,"pcpadd":"114 SUTHERLIN DR STE C1","pcpcity":"WARNER ROBINS","pcpstate":"GA","pcpzip":31088,"pcpcounty":"","pcpid":"","pcpname":"114 SUTHERLIN DR STE C1","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"520 Saint Marlo Dr","madd2":"","madd3":"","mcity":"Centerville","mstate":"GA","mzip":31028,"pcpfaxno":4787411354,"pcpnpi":1679689301,"currentgendcomment":"","pphycomment":"","uniqueid":457273,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I25.10","I10","E78.00","E03.9","E11.65","Z79.82","Z79.85","Z79.84","Z79.899","Z87.891","Z85.038","E11.9","Z68.25","E78.5","N42.9","R53.83","E53.9","E55.9","Z00.00","K76.0","R94.5","R07.9","R06.02","R00.2","R73.09","N18.2","Z68.27","C18.9","Z93.3","Z95.828","Z79.01","C18.7","D64.9","D70.8","D70.1","D64.81","D50.9","S05.02X","H57.12","W55.03X","K62.89","Z98.0","Z08","E83.52","Z68.26","Z98.890"],"date":["2025-06-03","2025-10-28","2025-10-28","2026-01-30","2025-06-03","2025-06-03","2025-06-03","2025-06-03","2026-01-30","2026-01-06","2026-01-06","2026-02-12","2025-06-25","2026-01-30","2026-01-30","2026-01-30","2026-01-30","2026-01-30","2026-02-12","2026-02-12","2026-02-12","2026-02-12","2026-02-12","2026-02-12","2026-03-14","2026-02-12","2026-02-12","2025-04-21","2025-06-03","2025-04-21","2026-03-14","2026-01-06","2026-01-06","2026-01-06","2026-01-06","2026-01-06","2026-01-06","2025-06-27","2025-06-27","2025-06-27","2025-04-03","2025-04-03","2025-06-02","2025-10-28","2025-10-28","2025-05-28"],"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":[["","","Metformin Hydrochloride","1000 MG","","Select","Select",""],["","","Mounjaro","","","Select","Select",""],["","","Levothyroxine Sodium","0.05 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Moxifloxacin","5 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","200 MG","","Select","Select",""],["","","Atorvastatin Calcium","","","Select","Select",""],["","","Fenofibrate","145 MG","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Magnesium Sulfate","0.0277 MEQ","","Select","Select",""],["","","Hydrocodone Bitartrate\/Acetaminophen","","","Select","Select",""],["","","Losartan Potassium","100 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":""}]}]}