{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Diane Aue","gend":1,"currentgend":"","add":"225 Brookwood Village Ln","city":"Cleveland","state":"GA","zip":"30528","dob":"1967-08-17","age":59,"mstatus":"","insh":"0009071326001","cliId":"","pno":"6782675596","cno":"6782675596","email":"lilmidnightwolf@gmail.com","ename":"","eno":"","pphy":"Nicholas Fox","ppno":"8437927199","pcpadd":"3320 OLD JEFFERSON RD BLDG 200","pcpcity":"ATHENS","pcpstate":"GA","pcpzip":"30607","pcpcounty":"","pcpid":"","pcpname":"3320 OLD JEFFERSON RD BLDG 200","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"225 Brookwood Village Ln","madd2":"","madd3":"","mcity":"Cleveland","mstate":"GA","mzip":"30528","pcpfaxno":"","pcpnpi":"1467748483","currentgendcomment":"","pphycomment":"","uniqueid":"517900","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z51.12","C50.919","Z17.421","Z68.23","C50.411","N63.11","I08.3","I27.22","I51.7","I27.21","Z79.899","G47.33","R06.02","D50.0","C50.811","I27.20","R04.0","N64.4","J34.2","Z68.25","C50.911","Z80.3","Z80.42","Z80.0","Z17.1","Z68.22","Z87.11","Z68.24","H66.91"],"date":["2026-06-26","2026-07-22","2026-07-22","2026-05-22","2026-05-22","2026-07-22","2026-04-16","2026-04-16","2026-04-16","2026-06-24","2026-06-24","2026-06-24","2026-06-24","2026-04-28","2026-06-05","2026-04-16","2026-03-19","2026-04-06","2026-02-17","2026-07-22","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-23","2026-04-23","2026-06-26","2026-06-29"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":[]},{"a":[]},{"a":[]}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"score":[0,0,0,0]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"arr":[],"comment":[]},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":[]},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":[]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"index":-1,"comment":"","sub":[]},{"a":[{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],["",""],{"comment":""}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","ESCITALOPRAM OXALATE","20000 MG","","Select","Select",""],["","","WINREVAIR","45000 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100000 MG","","Select","Select",""],["","","DIGOXIN","125000 MCG","","Select","Select",""],["","","ONDANSETRON ODT","8000 MG","","Select","Select",""],["","","LIDOCAINE\/PRILOCAINE","0","","Select","Select",""],["","","OPSYNVI","0","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40000 MG","","Select","Select",""],["","","CEFUROXIME AXETIL","500000 MG","","Select","Select",""],["","","CEPHALEXIN","500000 MG","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","10000 MG","","Select","Select",""],["","","BUTALBITAL\/ACETAMINOPHEN\/CAFFEINE","0","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":[]},{"a":[]}]},{"t":"Assessment of Diagnoses","q":[{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":[]},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"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":{"indx":["","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":[]},{"a":[""]},{"a":[]},{"a":[]},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":[]},{"a":[""]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","","","",""],"comment":["","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"2026-10-07T17:00","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"Virtual","a10":[],"a11":"","a12":"","a13":"","a15":[],"a14":"","a16":"","a18":"","a19":"","a20":"","a21":""}]}]}