{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Eriell S Hunter","gend":1,"currentgend":"","add":"508 Northside Dr","city":"Warner Robins","state":"GA","zip":"31093","dob":"1995-02-09","age":"","mstatus":"","insh":"0009043568001","cliId":"","pno":"5134069419","cno":"5134069419","email":"","ename":"","eno":"","pphy":"Samuel Palmer","ppno":"4789881282","pcpadd":"106 MORAN DR","pcpcity":"BONAIRE","pcpstate":"GA","pcpzip":"31005","pcpcounty":"","pcpid":"","pcpname":"106 MORAN DR","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"508 Northside Dr","madd2":"","madd3":"","mcity":"Warner Robins","mstate":"GA","mzip":"31093","pcpfaxno":"4789883120","pcpnpi":"1083663348","currentgendcomment":"","pphycomment":"","uniqueid":"477022","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":["Z11.3","N89.8","Z71.82","Z71.3","Z68.23","Z30.09","Z13.31","R10.9","Z68.22","D50.0","K90.49","R11.0","A59.9","Z13.9","D64.9","D69.6","R93.2","D57.80","D50.8","K90.89","E61.1","F33.9","R63.0","F41.1","N92.0","R93.89"],"date":["2026-01-09","2026-07-31","2026-06-15","2026-06-15","2026-06-09","2026-01-21","2026-01-21","2026-01-09","2026-05-01","2026-08-13","2026-07-07","2026-07-07","2026-06-15","2026-05-01","2026-06-29","2026-06-29","2026-06-29","2026-06-29","2026-06-29","2026-06-29","2026-05-14","2026-08-13","2026-08-13","2026-08-13","2026-06-29","2026-06-29"],"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":[["","","FLUCONAZOLE","150000 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","TERCONAZOLE","400 %","","Select","Select",""],["","","METRONIDAZOLE","500000 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","25000 MG","","Select","Select",""],["","","TRANEXAMIC ACID","650000 MG","","Select","Select",""],["","","ONDANSETRON ODT","8000 MG","","Select","Select",""],["","","METRONIDAZOLE VAGINAL","750 %","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","8000 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":""}]}]}