{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard Spires","gend":0,"currentgend":"","add":"118 Fairmont North Ct","city":"Macon","state":"GA","zip":"31210","dob":"1970-06-28","age":"","mstatus":"","insh":"0009049775001","cliId":"","pno":"4787199704","cno":"","email":"","ename":"","eno":"","pphy":"Charles Snow","ppno":"4784769285","pcpadd":"777 HEMLOCK ST","pcpcity":"MACON","pcpstate":"GA","pcpzip":"312012102","pcpcounty":"","pcpid":"","pcpname":"777 HEMLOCK ST","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"118 Fairmont North Ct","madd2":"","madd3":"","mcity":"Macon","mstate":"GA","mzip":"31210","pcpfaxno":"4784749034","pcpnpi":"1891873840","currentgendcomment":"","pphycomment":"","uniqueid":"486606","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":["D64.9","Z46.6","I12.9","N18.31","Z68.42","E66.01","Z79.01","N18.30","N20.0","M10.9","Z86.711","Z87.442","Z87.891","Z96.0","Z95.5","R30.0","N18.9","E79.0","R31.9","R80.9","D50.9","E66.09","Z01.810","I10","Z13.220","Z13.29","R00.2","M79.604","M79.605","R91.1","Z01.818","I49.8","I26.99","M54.30","K57.30","N13.2","M54.9","I49.9","I44.0","M54.50","T83.192","Z68.41","N18.32","G89.18","F32.A","R07.2","R00.0","M47.816","S39.012","R10.20","M43.16","M54.40"],"date":["2026-05-11","2026-05-11","2026-05-25","2026-05-25","2026-04-30","2026-05-21","2026-04-30","2026-05-25","2026-08-04","2026-04-30","2026-04-30","2026-04-30","2026-04-30","2026-05-24","2026-05-21","2026-05-11","2026-08-04","2026-08-04","2026-08-04","2026-08-04","2026-08-04","2026-08-04","2026-04-23","2026-04-23","2026-04-23","2026-04-23","2026-04-23","2026-04-23","2026-04-23","2026-04-23","2026-02-05","2026-02-05","2026-05-25","2026-03-05","2026-03-05","2026-03-05","2026-05-04","2026-05-24","2026-05-23","2026-05-01","2026-05-21","2026-05-21","2026-05-23","2026-05-24","2026-04-30","2026-04-23","2026-04-30","2026-05-07","2026-05-07","2026-07-30","2026-04-30","2026-03-05"],"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":[["","","ENOXAPARIN SODIUM","150000 MG\/ML","","Select","Select",""],["","","ALLOPURINOL","100000 MG","","Select","Select",""],["","","BACLOFEN","10000 MG","","Select","Select",""],["","","GABAPENTIN","100000 MG","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","0","","Select","Select",""],["","","CIPROFLOXACIN HYDROCHLORIDE","500000 MG","","Select","Select",""],["","","LEVOFLOXACIN","500000 MG","","Select","Select",""],["","","PREDNISONE","20000 MG","","Select","Select",""],["","","COLCHICINE","600 MG","","Select","Select",""],["","","TRAMADOL HYDROCHLORIDE","50000 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":""}]}]}