{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tashi Norris Cuyler","gend":1,"currentgend":"","add":"336 Graystone Pointe Dr","city":"Macon","state":"GA","zip":31211,"dob":"1977-09-13","age":"","mstatus":"","insh":"0009036555001","cliId":"","pno":4782780329,"cno":"","email":"","ename":"","eno":"","pphy":"Cornell Peters","ppno":4787558400,"pcpadd":"2040 BOWMAN PARK STE A","pcpcity":"MACON","pcpstate":"GA","pcpzip":31210,"pcpcounty":"","pcpid":"","pcpname":"2040 BOWMAN PARK STE A","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"336 Graystone Pointe Dr","madd2":"","madd3":"","mcity":"Macon","mstate":"GA","mzip":31211,"pcpfaxno":4787551073,"pcpnpi":1861487225,"currentgendcomment":"","pphycomment":"","uniqueid":468118,"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":["T45.1X5","C55","I50.32","E87.6","D64.9","D69.59","K12.30","R74.01","D25.9","M79.2","Z95.1","C49.9","D70.1","R19.7","R63.0","D21.9","B37.0","C79.51","D69.6","G90.513","K76.89","K52.1","G89.3","Z79.84","Z90.711","Z91.048","Z96.642","I45.81","R60.9","E87.8","K59.1","G90.50","R45.89","F41.9","G47.00","C56.9","R51.9","M51.17","M54.17","G57.12","G57.22","Z79.891","Z79.69","F32.9","G62.9","C76.3","M25.559","K21.9","K59.02","K62.5","R07.89","E43","M89.9","E87.79","R00.0","R06.02","R42","R60.0","R10.11","R10.9"],"date":["2025-11-25","2026-02-02","2026-01-23","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2026-01-23","2025-10-31","2025-10-15","2025-10-15","2025-10-31","2025-10-31","2025-10-31","2025-10-31","2025-10-27","2025-10-17","2025-10-17","2025-10-17","2025-10-17","2025-10-17","2025-10-17","2026-01-22","2025-10-17","2025-10-17","2025-10-17","2026-02-02","2025-09-17","2025-09-19","2025-09-19","2025-09-19","2025-05-05","2025-05-05","2026-01-13","2026-01-13","2025-05-05","2025-07-31","2026-01-22","2026-01-22","2026-01-22","2026-01-22","2026-01-22","2026-01-23","2026-01-13","2026-01-13","2026-01-13","2026-01-13","2026-01-13","2026-01-09","2026-01-09","2025-09-18","2025-10-15","2025-11-10","2025-09-18","2025-09-18","2025-09-18","2025-09-18","2025-09-18","2025-05-19","2025-08-11"],"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":[["","","Ondansetron","8 MG","","Select","Select",""],["","","Fluconazole","150 MG","","Select","Select",""],["","","Dexamethasone","","","Select","Select",""],["","","Atropine Sulfate","0.025 MG","","Select","Select",""],["","","Loperamide Hydrochloride","","","Select","Select",""],["","","Lidocaine\/Prilocaine","","","Select","Select",""],["","","Ketorolac Tromethamine","","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Sacubitril\/Valsartan","","","Select","Select",""],["","","Methocarbamol","750 MG","","Select","Select",""],["","","Eliquis","","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","Furosemide","","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","10 MG","","Select","Select",""],["","","Famotidine","20 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","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":""}]}]}