{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gladys Celhomme","gend":1,"currentgend":"","add":"2409 Holland Dr","city":"Macon","state":"GA","zip":"31206","dob":"1971-08-29","age":"","mstatus":"","insh":"0009052169001","cliId":"","pno":"8638777793","cno":"","email":"","ename":"","eno":"","pphy":"Warren Hutchings","ppno":"4786335500","pcpadd":"3780 EISENHOWER PKWY","pcpcity":"MACON","pcpstate":"GA","pcpzip":"31206","pcpcounty":"","pcpid":"","pcpname":"3780 EISENHOWER PKWY","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"2409 Holland Dr","madd2":"","madd3":"","mcity":"Macon","mstate":"GA","mzip":"31206","pcpfaxno":"4787845496","pcpnpi":"1396844908","currentgendcomment":"","pphycomment":"","uniqueid":"489912","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":["Z00.01","R01.1","I10","E11.9","E03.9","R06.02","Z12.31","Z11.4","Z12.11","Z11.59","Z13.220","R10.84","R12","R11.10","E66.9","Z13.818","Z80.0","Z28.21","E66.01","Z71.85","E78.00","G47.33","Z12.4","R00.2","R60.0","I34.0","I36.1","I47.10","I49.3","I49.1","Z86.010","I49.9","R92.313","R00.1"],"date":["2026-01-21","2026-02-04","2026-07-24","2026-07-24","2026-01-21","2026-02-04","2026-01-27","2026-01-21","2026-02-16","2026-01-21","2026-01-21","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-16","2026-03-12","2026-07-24","2026-03-12","2026-07-24","2026-02-06","2026-02-06","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-16","2026-02-16","2026-01-27","2026-01-21"],"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":[["","","METFORMIN HYDROCHLORIDE","500000 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","40000 MG","","Select","Select",""],["","","OZEMPIC","4000 MG\/3ML","","Select","Select",""],["","","LOSARTAN POTASSIUM","25000 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":""}]}]}