{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dennis Atteberry","gend":0,"currentgend":"","add":"160 Pine Level Rd","city":"Americus","state":"GA","zip":"31719","dob":"1966-12-27","age":"","mstatus":"","insh":"0009049447001","cliId":"","pno":"2299385338","cno":"","email":"","ename":"","eno":"","pphy":"Ramana Rao","ppno":"2294366688","pcpadd":"2002 PALMYRA RD STE 101","pcpcity":"ALBANY","pcpstate":"GA","pcpzip":"31701","pcpcounty":"","pcpid":"","pcpname":"2002 PALMYRA RD STE 101","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"160 Pine Level Rd","madd2":"","madd3":"","mcity":"Americus","mstate":"GA","mzip":"31719","pcpfaxno":"2294360307","pcpnpi":"1215920491","currentgendcomment":"","pphycomment":"","uniqueid":"486166","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":["I48.92","Z79.01","J44.9","G47.33","I10","I42.8","E78.5","Z79.899","I48.91","R06.02","I48.19","I48.0","I48.3","J96.01","I36.1","R94.31","Z01.810","R91.1","I50.9","J41.0","R10.9","R10.84","E78.2","R06.09","F17.200"],"date":["2026-05-04","2026-07-07","2026-07-07","2026-08-19","2026-08-19","2026-07-07","2026-07-07","2026-07-07","2026-07-07","2026-04-14","2026-08-19","2026-05-04","2026-05-04","2026-08-24","2026-05-04","2026-05-04","2026-05-04","2026-02-18","2026-03-17","2026-08-19","2026-08-19","2026-08-19","2026-08-19","2026-03-17","2026-03-17"],"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":[["","","ROSUVASTATIN CALCIUM","10000 MG","","Select","Select",""],["","","FENOFIBRATE","145000 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","30000 MG","","Select","Select",""],["","","ASPIRIN LOW DOSE","81000 MG","","Select","Select",""],["","","HYDRALAZINE HYDROCHLORIDE","25000 MG","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10000 MEQ","","Select","Select",""],["","","LOSARTAN POTASSIUM","100000 MG","","Select","Select",""],["","","AMIODARONE HYDROCHLORIDE","200000 MG","","Select","Select",""],["","","SYMBICORT","0","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25000 MG","","Select","Select",""],["","","ALBUTEROL SULFATE","83 %","","Select","Select",""],["","","ELIQUIS","5000 MG","","Select","Select",""],["","","ENOXAPARIN SODIUM","150000 MG\/ML","","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":""}]}]}