{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ema Silva","gend":1,"currentgend":"","add":"501 Morningside Dr Apt 3","city":"Dalton","state":"GA","zip":"30721","dob":"1969-03-10","age":"","mstatus":"","insh":"0009064744001","cliId":"","pno":"6514048499","cno":"6514048499","email":"ilusion03122226@gmail.com","ename":"","eno":"","pphy":"Lisa Duhaime","ppno":"7062268950","pcpadd":"1200 MEMORIAL DR","pcpcity":"DALTON","pcpstate":"GA","pcpzip":"30720","pcpcounty":"","pcpid":"","pcpname":"1200 MEMORIAL DR","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"Apt 3","add3":"","madd1":"501 Morningside Dr Apt 3","madd2":"Apt 3","madd3":"","mcity":"Dalton","mstate":"GA","mzip":"30721","pcpfaxno":"7062726836","pcpnpi":"1083697494","currentgendcomment":"","pphycomment":"","uniqueid":"508605","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":["C50.411","Z17.31","M81.0","D70.1","S92.311","S80.212","Z92.3","S80.11X","M25.561","S20.219","R94.31","C50.911","E87.6","E55.9","R92.8","T45.1X5","Z12.31","G89.18","M79.671","Z17.0","F33.1","I42.7","F41.9","I89.0","F51.01","K62.5","J45.20","M85.89","R91.8","Z12.4","R01.1","S90.811","R07.9"],"date":["2026-08-20","2026-08-20","2026-08-20","2026-07-23","2026-06-10","2026-03-22","2026-03-22","2026-03-22","2026-03-22","2026-03-22","2026-03-22","2026-07-23","2026-07-23","2026-07-23","2026-07-23","2026-07-23","2026-07-23","2026-04-30","2026-06-10","2026-08-20","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-05-26","2026-03-21","2026-03-21","2026-03-22"],"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":[["","","PAROXETINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","0","","Select","Select",""],["","","IBUPROFEN","600000 MG","","Select","Select",""],["","","LETROZOLE","2500 MG","","Select","Select",""],["","","LORAZEPAM","500 MG","","Select","Select",""],["","","ONDANSETRON ODT","4000 MG","","Select","Select",""],["","","CEPHALEXIN","500000 MG","","Select","Select",""],["","","ALENDRONATE SODIUM","70000 MG","","Select","Select",""],["","","TAMOXIFEN CITRATE","20000 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":""}]}]}