{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Tonya Boykin","gend":1,"currentgend":"","add":"607 Dock Hyde Rd","city":"Carrollton","state":"GA","zip":"30116","dob":"1973-11-23","age":"","mstatus":"","insh":"0009051554001","cliId":"","pno":"6787096200","cno":"","email":"tlboykin44@yahoo.com","ename":"","eno":"","pphy":"Cheryl Augenstein","ppno":"7704221372","pcpadd":"6095 PROFESSIONAL PKWY STE A200","pcpcity":"DOUGLASVILLE","pcpstate":"GA","pcpzip":"30134","pcpcounty":"","pcpid":"","pcpname":"6095 PROFESSIONAL PKWY STE A200","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"607 Dock Hyde Rd","madd2":"","madd3":"","mcity":"Carrollton","mstate":"GA","mzip":"30116","pcpfaxno":"7709992611","pcpnpi":"1801259528","currentgendcomment":"","pphycomment":"","uniqueid":"489173","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":["R56.9","Z12.11","E04.9","Z86.73","E11.9","I10","G47.33","D12.2","D12.4","J45.909","K64.8","Z79.899","Z79.51","Z88.8","Z68.41","E21.3","G47.30","R47.1","J45.20","R20.2","M47.26","R74.8","E04.1","E04.2","E55.9","E66.813","E66.01","J42","J30.1","M16.7","D12.3","Z01.419","M67.471","E11.42","M20.11","M20.12","J34.2","J34.3","J35.1","M72.2","G45.9","R19.8"],"date":["2026-06-11","2026-06-07","2026-04-01","2026-06-04","2026-06-12","2026-06-04","2026-08-14","2026-06-03","2026-06-03","2026-06-08","2026-06-03","2026-06-03","2026-06-03","2026-06-03","2026-06-12","2026-06-12","2026-03-03","2026-05-27","2026-03-25","2026-03-03","2026-03-03","2026-04-13","2026-06-12","2026-06-12","2026-06-12","2026-06-12","2026-06-03","2026-03-26","2026-03-25","2026-06-04","2026-06-03","2026-04-21","2026-08-04","2026-03-27","2026-03-27","2026-03-27","2026-07-02","2026-07-02","2026-07-02","2026-08-04","2026-06-11","2026-05-15"],"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":[["","","OZEMPIC","8000 MG\/3ML","","Select","Select",""],["","","CLOPIDOGREL","75000 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","108000 MCG\/ACT","","Select","Select",""],["","","SYMBICORT","0","","Select","Select",""],["","","AZELASTINE HYDROCHLORIDE","137000 MCG\/SPRAY","","Select","Select",""],["","","METFORMIN HYDROCHLORIDE ER","500000 MG","","Select","Select",""],["","","DEXAMETHASONE","1000 MG","","Select","Select",""],["","","GAVILYTE-G","0","","Select","Select",""],["","","AMLODIPINE BESYLATE","5000 MG","","Select","Select",""],["","","MOUNJARO","7500 MG\/0.5ML","","Select","Select",""],["","","LOSARTAN POTASSIUM\/HYDROCHLOROTHIAZIDE","0","","Select","Select",""],["","","ALBUTEROL SULFATE","1250 MG\/3ML","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80000 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":""}]}]}