{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joyce Downey","gend":1,"currentgend":"","add":"401 Little Mac Ln","city":"Villa Rica","state":"GA","zip":30180,"dob":"1965-02-03","age":"","mstatus":"","insh":"0009040336001","cliId":"","pno":6788909311,"cno":"","email":"","ename":"","eno":"","pphy":"Jeffrey Cox","ppno":6785678000,"pcpadd":"662 CARROLLTON VILLA RICA HWY STE 200","pcpcity":"VILLA RICA","pcpstate":"GA","pcpzip":30180,"pcpcounty":"","pcpid":"","pcpname":"662 CARROLLTON VILLA RICA HWY STE 200","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"401 Little Mac Ln","madd2":"","madd3":"","mcity":"Villa Rica","mstate":"GA","mzip":30180,"pcpfaxno":7704393555,"pcpnpi":1124290549,"currentgendcomment":"","pphycomment":"","uniqueid":472332,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M54.2","G89.4","M54.50","E87.1","J21.9","J44.1","J44.0","J10.1","F17.210","M50.30","Z11.52","Z71.6","Z12.31","R92.323","Z13.220","Z13.1","R09.02","Z13.29","J96.01","J44.9","Z99.81","R74.8","R79.89","K57.90","D25.9","Z12.4","Z12.11","J84.89","R06.00","M54.12","M46.1","M79.10","Z79.891"],"date":["2026-01-27","2026-01-27","2026-01-27","2025-12-24","2025-12-24","2026-02-28","2025-12-24","2025-12-24","2025-12-24","2026-01-26","2025-12-24","2025-12-24","2026-02-25","2026-02-25","2026-02-17","2026-02-17","2026-02-17","2026-02-17","2025-12-26","2026-01-26","2026-01-26","2026-01-26","2026-01-26","2026-01-26","2026-01-26","2026-01-26","2026-01-26","2025-12-24","2025-12-24","2025-11-14","2025-11-14","2025-11-14","2025-11-14"],"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":[["","","Pregabalin","50 MG","","Select","Select",""],["","","Oseltamivir","75 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Nda020503 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Celecoxib","100 MG","","Select","Select",""],["","","Azithromycin","500 MG","","Select","Select",""],["","","Prednisone","20 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":""}]}]}