{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael Hudson","gend":0,"currentgend":"","add":"198 Orchid Rd","city":"Rochelle","state":"GA","zip":"31079","dob":"1964-01-30","age":"","mstatus":"","insh":"0009045745001","cliId":"","pno":"2293134662","cno":"2293134662","email":"","ename":"","eno":"","pphy":"David Cox","ppno":"4789880022","pcpadd":"902 N 7TH ST","pcpcity":"CORDELE","pcpstate":"GA","pcpzip":"31015","pcpcounty":"","pcpid":"","pcpname":"902 N 7TH ST","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"198 Orchid Rd","madd2":"","madd3":"","mcity":"Rochelle","mstate":"GA","mzip":"31079","pcpfaxno":"4789870444","pcpnpi":"1417102393","currentgendcomment":"","pphycomment":"","uniqueid":"479912","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":["I10","E78.2","I50.9","K21.9","J30.9","E29.1","N52.9","G47.9","F41.9","R79.89","D72.829","I11.0","I48.92","I25.10","Z79.899","I48.91","R06.00","R07.9","R00.2","R06.02"],"date":["2026-08-11","2026-06-10","2026-08-10","2026-06-10","2026-06-10","2026-06-10","2026-06-10","2026-06-10","2026-08-10","2026-08-10","2026-08-11","2026-08-10","2026-08-11","2026-08-10","2026-08-10","2026-08-10","2026-08-11","2026-08-10","2026-08-11","2026-08-11"],"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":[["","","METOPROLOL SUCCINATE ER","25000 MG","","Select","Select",""],["","","TESTOSTERONE CYPIONATE","200000 MG\/ML","","Select","Select",""],["","","REPATHA SURECLICK","140000 MG\/ML","","Select","Select",""],["","","HYDRALAZINE HYDROCHLORIDE","25000 MG","","Select","Select",""],["","","LEVOCETIRIZINE DIHYDROCHLORIDE","5000 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40000 MG","","Select","Select",""],["","","LISINOPRIL","20000 MG","","Select","Select",""],["","","ELIQUIS","5000 MG","","Select","Select",""],["","","FUROSEMIDE","40000 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50000 MG","","Select","Select",""],["","","AMIODARONE HYDROCHLORIDE","200000 MG","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50000 MCG\/ACT","","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":""}]}]}