{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Marisol Garcia","gend":1,"currentgend":"","add":"329 Sycamore Cir","city":"Dalton","state":"GA","zip":"30721","dob":"1971-12-07","age":"","mstatus":"","insh":"0009046295002","cliId":"","pno":"7062606058","cno":"7065080115","email":"","ename":"","eno":"","pphy":"Timothy Snodgrass","ppno":"7065293245","pcpadd":"1107 MEMORIAL DR STE 200","pcpcity":"DALTON","pcpstate":"GA","pcpzip":"30720","pcpcounty":"","pcpid":"","pcpname":"1107 MEMORIAL DR STE 200","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"329 Sycamore Cir","madd2":"","madd3":"","mcity":"Dalton","mstate":"GA","mzip":"30721","pcpfaxno":"7062726077","pcpnpi":"1962484055","currentgendcomment":"","pphycomment":"","uniqueid":"481776","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Spanish"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R93.3","I10","R07.9","M54.89","E11.9","E03.9","Z60.3","R93.5","Z12.11","K29.60","E11.00","E78.2","E55.9","R22.1","K29.50","K31.89","E78.5","B07.0","Z79.85","Z53.20","R10.32","R10.9","I23.1","R94.31","Z13.6","Z12.12","Z12.31","R93.89"],"date":["2026-01-31","2026-05-13","2026-01-31","2026-01-31","2026-06-05","2026-08-12","2026-01-31","2026-03-05","2026-03-05","2026-03-05","2026-08-17","2026-05-13","2026-05-13","2026-05-14","2026-03-05","2026-03-05","2026-03-05","2026-08-12","2026-08-12","2026-08-12","2026-03-05","2026-01-31","2026-02-02","2026-02-02","2026-02-02","2026-02-04","2026-08-03","2026-01-31"],"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":[["","","FENOFIBRATE","54000 MG","","Select","Select",""],["","","LOVASTATIN","20000 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","0","","Select","Select",""],["","","OZEMPIC","8000 MG\/3ML","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","137000 MCG","","Select","Select",""],["","","VITAMIN D","1250 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","50000 MG","","Select","Select",""],["","","SODIUM SULFATE\/POTASSIUM SULFATE\/MAGNESIUM SULFATE","0","","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":""}]}]}