{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Angela Whitaker","gend":1,"currentgend":"","add":"603 New Phoenix Rd","city":"Eatonton","state":"GA","zip":"31024","dob":"1978-09-18","age":"","mstatus":"","insh":"0009080819001","cliId":"","pno":"7068163433","cno":"7068163433","email":"awhitaker206@gmail.com","ename":"","eno":"","pphy":"Petros Nikolinakos","ppno":"7063532990","pcpadd":"3320 OLD JEFFERSON RD BLDG 700","pcpcity":"ATHENS","pcpstate":"GA","pcpzip":"30607","pcpcounty":"","pcpid":"","pcpname":"3320 OLD JEFFERSON RD BLDG 700","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"603 New Phoenix Rd","madd2":"","madd3":"","mcity":"Eatonton","mstate":"GA","mzip":"31024","pcpfaxno":"7063532992","pcpnpi":"1306041900","currentgendcomment":"","pphycomment":"","uniqueid":"529712","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":["D64.9","R79.89","E55.9","Z76.89","Z01.818","Z90.710","N80.03","N88.8","N32.89","N73.6","D50.9","K21.9","I10","E78.2","E03.9","Z79.899","Z86.69","F51.01","Z86.59","D25.1","N92.1","D25.9","N84.0","Z98.891","I25.10","M25.572","Z01.810","M19.072","M79.89","Z12.31","Z12.11","Z87.19","Z87.11","K56.699","D50.0","K44.9","K57.30","K31.89","K55.9","K29.50"],"date":["2026-07-13","2026-07-16","2026-07-16","2026-04-06","2026-03-20","2026-03-20","2026-03-23","2026-03-23","2026-03-23","2026-03-23","2026-07-27","2026-07-20","2026-07-16","2026-07-16","2026-07-16","2026-07-27","2026-03-09","2026-03-09","2026-03-09","2026-02-12","2026-04-08","2026-03-23","2026-03-20","2026-03-20","2026-03-23","2026-07-31","2026-04-08","2026-07-31","2026-07-31","2026-06-24","2026-07-20","2026-06-24","2026-07-20","2026-07-20","2026-03-23","2026-07-20","2026-07-20","2026-07-20","2026-07-20","2026-07-20"],"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":[["","","VENLAFAXINE HYDROCHLORIDE ER","150000 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40000 MG","","Select","Select",""],["","","NORETHINDRONE","350 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","20000 MG","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","25000 MG","","Select","Select",""],["","","DICLOFENAC SODIUM DR","75000 MG","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","100000 MCG","","Select","Select",""],["","","HYDROXYZINE PAMOATE","25000 MG","","Select","Select",""],["","","SUCRALFATE","1000 GM","","Select","Select",""],["","","GEMFIBROZIL","600000 MG","","Select","Select",""],["","","ONDANSETRON HYDROCHLORIDE","4000 MG","","Select","Select",""],["","","ONDANSETRON ODT","8000 MG","","Select","Select",""],["","","ATENOLOL","50000 MG","","Select","Select",""],["","","HYDROCODONE BITARTRATE\/ACETAMINOPHEN","0","","Select","Select",""],["","","PEG-","0","","Select","Select",""],["","","PREDNISONE","20000 MG","","Select","Select",""],["","","MESALAMINE DR","1200 GM","","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":""}]}]}