{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gidget Preacely","gend":1,"currentgend":"","add":"215 Tracy Ter","city":"Warner Robins","state":"GA","zip":"31088","dob":"1967-03-13","age":"","mstatus":"","insh":"0009044890001","cliId":"","pno":"3216956615","cno":"","email":"gpreacely@yahoo.com","ename":"","eno":"","pphy":"Briana Birdsong","ppno":"4784050045","pcpadd":"506 OSIGIAN BLVD STE 4","pcpcity":"WARNER ROBINS","pcpstate":"GA","pcpzip":"31088","pcpcounty":"","pcpid":"","pcpname":"506 OSIGIAN BLVD STE 4","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"215 Tracy Ter","madd2":"","madd3":"","mcity":"Warner Robins","mstate":"GA","mzip":"31088","pcpfaxno":"4784050054","pcpnpi":"1235715624","currentgendcomment":"","pphycomment":"","uniqueid":"478764","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":["R00.0","Z12.31","Z00.00","E11.22","I13.0","I50.9","E78.2","I48.0","E03.9","E55.9","Z79.899","Z72.51","Z11.3","I49.01","I50.21","I47.21","Z68.41","I42.8","I47.19","R13.10","I11.0","E11.69","D64.9","K50.90","E66.813","E87.6","I25.10","K21.9","E78.49","K59.03","T39.95X","R00.1","R09.02","R53.83","R91.8","Z87.891","E11.9","Z79.84","I10","E78.5","K59.00","R20.0","Z68.42","Z71.89","R11.10","R10.9","R06.02","R11.2","F11.90","R07.9","Z88.0","Z88.8","R10.13","R79.89","R09.1","J32.8","E66.01","N18.1","M54.16","M54.2","G89.4","E66.9","D50.9","M79.674","M79.89","I13.10","R30.0","R35.0","B37.31","I47.10","Z95.818","Z09","E11.65","F11.20","Z95.810","I50.22","I51.89","I51.7","I51.9","Z68.43","E83.42","R53.1","J40","D72.829","Z45.02","I47.20","Z45.09","Z13.31","Z13.89","Z76.89","N18.9","Z71.3","R92.313","I49.9","I48.92","I47.29","Z95.0","I49.3","I45.9","J42","J20.9","R04.0","J98.09","J98.11","I48.91","Z79.01","K59.01","M54.6","I50.41","I50.20","R09.81","J31.0","E86.0","R94.31","S90.121","Z98.890"],"date":["2026-01-28","2026-05-11","2026-04-16","2026-08-07","2026-05-20","2026-05-20","2026-07-24","2026-07-24","2026-07-31","2026-07-23","2026-05-20","2026-04-16","2026-06-25","2026-08-03","2026-01-30","2026-01-20","2026-01-23","2026-01-20","2026-08-03","2026-01-20","2026-07-31","2026-01-20","2026-01-20","2026-05-27","2026-07-31","2026-01-22","2026-07-31","2026-03-19","2026-01-20","2026-01-20","2026-01-20","2026-01-30","2026-01-20","2026-01-20","2026-02-11","2026-07-31","2026-08-03","2026-01-23","2026-08-03","2026-01-27","2026-03-03","2026-03-03","2026-05-27","2026-03-03","2026-01-20","2026-01-20","2026-01-20","2026-01-12","2026-01-12","2026-01-14","2026-04-17","2026-04-17","2026-01-12","2026-01-12","2026-01-12","2026-04-13","2026-05-20","2026-05-20","2026-05-20","2026-05-20","2026-05-20","2026-05-27","2026-07-23","2026-04-17","2026-07-24","2026-07-23","2026-04-10","2026-04-10","2026-04-10","2026-08-02","2026-01-25","2026-02-25","2026-02-25","2026-06-08","2026-08-03","2026-08-03","2026-01-23","2026-01-23","2026-01-23","2026-07-31","2026-08-03","2026-01-26","2026-01-29","2026-01-25","2026-01-29","2026-01-29","2026-01-29","2026-02-11","2026-02-11","2026-02-11","2026-04-10","2026-04-10","2026-05-11","2026-08-03","2026-07-24","2026-07-24","2026-08-02","2026-08-02","2026-08-02","2026-02-17","2026-01-25","2026-04-13","2026-04-21","2026-01-29","2026-01-29","2026-01-28","2026-01-12","2026-01-12","2026-01-27","2026-08-03","2026-04-13","2026-04-16","2026-01-20","2026-08-03","2026-04-17","2026-01-23"],"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":[["","","SUCRALFATE","1000 GM","","Select","Select",""],["","","METOCLOPRAMIDE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","FLECAINIDE ACETATE","100000 MG","","Select","Select",""],["","","ASPIRIN","81000 MG","","Select","Select",""],["","","SYMBICORT","0","","Select","Select",""],["","","AMIODARONE HYDROCHLORIDE","100000 MG","","Select","Select",""],["","","IPRATROPIUM BROMIDE\/ALBUTEROL SULFATE","0","","Select","Select",""],["","","LEVOCETIRIZINE DIHYDROCHLORIDE","5000 MG","","Select","Select",""],["","","RABEPRAZOLE SODIUM","20000 MG","","Select","Select",""],["","","AZELASTINE HYDROCHLORIDE","100 %","","Select","Select",""],["","","MUPIROCIN","2000 %","","Select","Select",""],["","","LACTULOSE","10000 GM\/15ML","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100000 MG","","Select","Select",""],["","","FLUCONAZOLE","150000 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","10000 MG","","Select","Select",""],["","","FAMOTIDINE","40000 MG","","Select","Select",""],["","","METHYLPREDNISOLONE DOSE PACK","4000 MG","","Select","Select",""],["","","SPIRONOLACTONE","25000 MG","","Select","Select",""],["","","SOTALOL HCL","120000 MG","","Select","Select",""],["","","ACETAMINOPHEN\/CODEINE","0","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","125000 MCG","","Select","Select",""],["","","MOUNJARO","7500 MG\/0.5ML","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","30000 MG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","0","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE","1000000 MG","","Select","Select",""],["","","ELIQUIS","5000 MG","","Select","Select",""],["","","SACUBITRIL\/VALSARTAN","0","","Select","Select",""],["","","MEXILETINE HYDROCHLORIDE","150000 MG","","Select","Select",""],["","","SYNJARDY XR","0","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","100000 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50000 MCG\/ACT","","Select","Select",""],["","","CLINDAMYCIN HYDROCHLORIDE","300000 MG","","Select","Select",""],["","","VITAMIN D","1250 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","0","","Select","Select",""],["","","GABAPENTIN","100000 MG","","Select","Select",""],["","","DOFETILIDE","250000 MCG","","Select","Select",""],["","","OZEMPIC","2000 MG\/3ML","","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":""}]}]}