{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dieter Buehler","gend":0,"currentgend":"","add":"3833 Billabong Trl","city":"Gainesville","state":"GA","zip":30506,"dob":"1962-08-21","age":"","mstatus":"","insh":"0009035032001","cliId":"","pno":3105083641,"cno":"","email":"dieterbuehler1962@gmail.com","ename":"","eno":"","pphy":"Andrew Johnson","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":"3833 Billabong Trl","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30506,"pcpfaxno":7707181877,"pcpnpi":1497045553,"currentgendcomment":"","pphycomment":"","uniqueid":466439,"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":["E04.2","R79.89","C64.2","E11.9","I11.9","F41.9","E78.5","E83.42","N28.89","Z79.01","Z79.899","Z91.148","Z82.49","E86.0","Z23","R91.1","I48.91","Z68.31","Z51.81","I10","K21.9","Z79.84","Z79.85","Z90.5","Z87.448","N18.32","Z68.32","I48.0","E06.3","Z68.34","E87.5","Z68.30","Z13.6","N17.9","N28.0","I49.9","I12.9","E11.22","Z00.01","Z11.4","D72.829","Z12.5","E78.2","Z29.11","Z13.31","Z13.39","N18.31","E11.65","G89.18","D35.02","I50.9","Z12.11","Z01.818","E04.1","I48.11","Z11.59","I35.1","R06.02"],"date":["2026-02-17","2026-02-10","2026-03-12","2026-03-12","2025-10-31","2025-07-14","2025-07-14","2025-07-14","2025-07-14","2026-01-07","2025-07-23","2025-07-14","2025-07-14","2025-10-22","2025-10-22","2025-12-26","2026-02-26","2025-12-17","2026-01-07","2026-03-12","2025-07-23","2025-07-23","2025-07-23","2026-03-12","2026-03-12","2026-03-12","2026-01-07","2025-08-01","2026-02-17","2026-02-17","2025-10-22","2025-11-12","2025-10-14","2025-11-21","2025-07-23","2025-07-14","2026-03-12","2026-03-12","2025-10-14","2025-10-14","2025-10-14","2025-10-14","2026-02-05","2025-10-14","2025-10-14","2025-10-14","2025-08-25","2025-08-25","2025-07-23","2025-07-14","2025-07-14","2026-02-26","2025-07-14","2026-02-13","2026-02-05","2025-10-14","2025-08-15","2025-07-14"],"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":[["","","Atorvastatin","10 MG","","Select","Select",""],["","","Prochlorperazine","10 MG","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Glipizide","","","Select","Select",""],["","","Lokelma","","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Eliquis","","","Select","Select",""],["","","Metoprolol Tartrate","","","Select","Select",""],["","","Onetouch Delica Plus Lancets Fine","30 G","","Select","Select",""],["","","Levothyroxine Sodium","0.175 MG","","Select","Select",""],["","","24 Hr Diltiazem Hydrochloride","360 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Metformin Hydrochloride","1000 MG","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Icosapent Ethyl","1000 MG","","Select","Select",""],["","","Ergocalciferol","1.25 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":""}]}]}