{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Nina Arrendale","gend":1,"currentgend":"","add":"1337 Old Dalton Ellijay Rd Apt 4","city":"Chatsworth","state":"GA","zip":"30705","dob":"1964-03-23","age":"","mstatus":"","insh":"0009056115001","cliId":"","pno":"7064638967","cno":"7622197556","email":"ninawilliams1964@gmail.com","ename":"","eno":"","pphy":"Yonas Tamene","ppno":"7708123530","pcpadd":"20 HERRELL RD","pcpcity":"VILLA RICA","pcpstate":"GA","pcpzip":"30180","pcpcounty":"","pcpid":"","pcpname":"20 HERRELL RD","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1337 Old Dalton Ellijay Rd Apt 4","madd2":"","madd3":"","mcity":"Chatsworth","mstate":"GA","mzip":"30705","pcpfaxno":"7708123531","pcpnpi":"1679097893","currentgendcomment":"","pphycomment":"","uniqueid":"338936","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":["T50.901","R45.851","D50.9","E78.5","F41.9","F43.10","F60.3","G89.29","K59.00","R45.850","F32.9","M79.7","T50.912","E66.9","M19.90","R94.31","Z56.0","Z60.9","Z79.899","Z68.31","Z71.3","F32.A","R44.3","I21.9","J01.80","Z76.89","Z13.31","F99","R53.81","E66.3","R79.9","E78.2","R41.3","T43.212","T50.992"],"date":["2026-01-18","2026-02-11","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-19","2026-01-17","2026-01-17","2026-01-17","2026-01-17","2026-01-17","2026-01-17","2026-01-17","2026-01-17","2026-01-16","2026-01-16","2026-01-17","2026-08-06","2026-08-06","2026-08-06","2026-01-16","2026-02-25","2026-02-25","2026-02-06","2026-02-06","2026-02-06","2026-01-16","2026-01-16"],"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":[["","","DICLOFENAC SODIUM DR","75000 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","150000 MG","","Select","Select",""],["","","DULOXETINE HYDROCHLORIDE DR","30000 MG","","Select","Select",""],["","","CITALOPRAM HYDROBROMIDE","20000 MG","","Select","Select",""],["","","BUSPIRONE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","RISPERIDONE","1000 MG","","Select","Select",""],["","","OXCARBAZEPINE","300000 MG","","Select","Select",""],["","","ARIPIPRAZOLE","5000 MG","","Select","Select",""],["","","MONTELUKAST SODIUM","10000 MG","","Select","Select",""],["","","VITAMIN D","50000000 UNIT","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","10000 MG","","Select","Select",""],["","","CYANOCOBALAMIN","1000000 MCG\/ML","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","AMOXICILLIN","875000 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":""}]}]}