{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Antonia Butler-Love","gend":1,"currentgend":"","add":"300 Moultrie Rd Apt 12","city":"Albany","state":"GA","zip":"31705","dob":"1979-01-13","age":"","mstatus":"","insh":"0009065233001","cliId":"","pno":"2296036026","cno":"2296036026","email":"","ename":"","eno":"","pphy":"Kayla Lovett","ppno":"4787411208","pcpadd":"304 MARGIE DR","pcpcity":"WARNER ROBINS","pcpstate":"GA","pcpzip":"31088","pcpcounty":"","pcpid":"","pcpname":"304 MARGIE DR","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"Apt 12","add3":"","madd1":"300 Moultrie Rd Apt 12","madd2":"Apt 12","madd3":"","mcity":"Albany","mstate":"GA","mzip":"31705","pcpfaxno":"","pcpnpi":"1902327679","currentgendcomment":"","pphycomment":"","uniqueid":"509241","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":["D25.9","N83.291","R16.0","R10.31","N83.201","N39.0","Z79.899","R23.2","R61","N89.8","R10.23","F41.1","R00.0","R55","J45.998","Z86.79","J45.22","I50.89","D25.1","N73.6","Z20.2","A59.9","Z32.02","J30.89","M54.12","M54.16","G89.4","Z09","N83.02","E34.9","Z79.891","Z12.31","Z01.419","Z12.4","I34.0","I36.1","R51.9","A59.00","K21.9","R76.89","Z12.11","F17.200","M54.2","V87.7XX","I47.10","I49.3"],"date":["2026-06-22","2026-05-26","2026-05-26","2026-05-27","2026-05-25","2026-05-25","2026-05-25","2026-05-28","2026-05-28","2026-05-28","2026-08-07","2026-07-28","2026-06-05","2026-06-05","2026-02-18","2026-02-18","2026-02-18","2026-02-18","2026-06-22","2026-06-22","2026-06-19","2026-06-18","2026-06-18","2026-02-23","2026-06-02","2026-07-14","2026-07-14","2026-07-06","2026-05-28","2026-05-28","2026-07-14","2026-07-06","2026-05-28","2026-05-28","2026-06-05","2026-06-05","2026-03-27","2026-06-18","2026-05-07","2026-05-07","2026-05-07","2026-05-27","2026-03-27","2026-03-27","2026-05-12","2026-05-12"],"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":[["","","DILTIAZEM HYDROCHLORIDE ER","180000 MG","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","108000 MCG\/ACT","","Select","Select",""],["","","OXYCODONE\/ACETAMINOPHEN","0","","Select","Select",""],["","","OXYCODONE HYDROCHLORIDE","15000 MG","","Select","Select",""],["","","PREGABALIN","100000 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25000 MG","","Select","Select",""],["","","AZELASTINE HYDROCHLORIDE","137000 MCG\/SPRAY","","Select","Select",""],["","","DUPIXENT","300000 MG\/2ML","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","10000 MG","","Select","Select",""],["","","CYCLOBENZAPRINE HYDROCHLORIDE","5000 MG","","Select","Select",""],["","","MELOXICAM","15000 MG","","Select","Select",""],["","","METOPROLOL SUCCINATE ER","50000 MG","","Select","Select",""],["","","ONDANSETRON ODT","4000 MG","","Select","Select",""],["","","GAVILYTE-G","0","","Select","Select",""],["","","IBUPROFEN","800000 MG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4000 MG","","Select","Select",""],["","","FLUCONAZOLE","150000 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40000 MG","","Select","Select",""],["","","MUPIROCIN","2000 %","","Select","Select",""],["","","OFLOXACIN","300 %","","Select","Select",""],["","","AMOXICILLIN\/CLAVULANATE POTASSIUM","0","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","120 %","","Select","Select",""],["","","FLUTICASONE PROPIONATE","50000 MCG\/ACT","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","100 %","","Select","Select",""],["","","POTASSIUM CHLORIDE ER","10000 MEQ","","Select","Select",""],["","","PREDNISONE","10000 MG","","Select","Select",""],["","","TACROLIMUS","100 %","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM DS","0","","Select","Select",""],["","","METRONIDAZOLE","500000 MG","","Select","Select",""],["","","ZOLPIDEM TARTRATE","5000 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":""}]}]}