{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lucrecia DE LOS ANGELES Lopez Cascante","gend":1,"currentgend":"","add":"705 Baskins Cir","city":"Winder","state":"GA","zip":"30680","dob":"1973-08-15","age":"","mstatus":"","insh":"0009060537001","cliId":"","pno":"4708943038","cno":"4708943038","email":"","ename":"","eno":"","pphy":"Mushtaq Ahmed","ppno":"7708676633","pcpadd":"133 W ATHENS ST","pcpcity":"WINDER","pcpstate":"GA","pcpzip":"30680","pcpcounty":"","pcpid":"","pcpname":"133 W ATHENS ST","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"705 Baskins Cir","madd2":"","madd3":"","mcity":"Winder","mstate":"GA","mzip":"30680","pcpfaxno":"","pcpnpi":"1457592552","currentgendcomment":"","pphycomment":"","uniqueid":"502796","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["Spanish"]],"comment":[[]],"sub":[]}}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G89.29","Z60.3","E11.9","E78.2","I11.0","I50.22","I25.10","K21.9","G47.00","E66.01","F33.9","F41.1","F33.1","N20.0","R31.0","I83.893","R00.2","G44.209","Z68.43","I83.813","I10","M54.50","R07.89","I50.42","I42.0","I23.6"],"date":["2026-05-11","2026-05-11","2026-05-14","2026-05-14","2026-04-20","2026-04-20","2026-05-14","2026-02-16","2026-02-16","2026-02-16","2026-04-20","2026-08-05","2026-08-05","2026-06-22","2026-06-22","2026-07-20","2026-05-14","2026-03-17","2026-07-20","2026-07-20","2026-05-14","2026-05-11","2026-05-14","2026-05-14","2026-05-14","2026-05-14"],"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":[["","","POTASSIUM CHLORIDE ER","10000 MEQ","","Select","Select",""],["","","ASPIRIN LOW DOSE","81000 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","80000 MG","","Select","Select",""],["","","FLUOXETINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","SACUBITRIL\/VALSARTAN","0","","Select","Select",""],["","","SPIRONOLACTONE","25000 MG","","Select","Select",""],["","","TRULICITY","1500 MG\/0.5ML","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","FUROSEMIDE","20000 MG","","Select","Select",""],["","","OMEPRAZOLE","40000 MG","","Select","Select",""],["","","TRAZODONE HYDROCHLORIDE","50000 MG","","Select","Select",""],["","","CARVEDILOL","3125 MG","","Select","Select",""],["","","JARDIANCE","25000 MG","","Select","Select",""],["","","IBUPROFEN","600000 MG","","Select","Select",""],["","","ASPIRIN","81000 MG","","Select","Select",""],["","","NITROGLYCERIN","400 MG","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","100 %","","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":""}]}]}