{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Zoey Sharp","gend":1,"currentgend":"","add":"1209 Piedmont Way","city":"Gainesville","state":"GA","zip":"30501","dob":"2013-04-22","age":"","mstatus":"","insh":"0009086105003","cliId":"","pno":"4043100070","cno":"4043100070","email":"","ename":"","eno":"","pphy":"Gary Jordan","ppno":"7702197777","pcpadd":"597 S ENOTA DR NE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":"30501","pcpcounty":"","pcpid":"","pcpname":"597 S ENOTA DR NE","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1209 Piedmont Way","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":"30501","pcpfaxno":"7702197778","pcpnpi":"1134344195","currentgendcomment":"","pphycomment":"","uniqueid":"536178","medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":{"0":{"a":{"diag":["F33.2","F41.1","F12.90","F12.10","Z91.52","Z79.899","F90.9","S62.101","M25.531","Z68.51","Z00.129","Z68.53","Z71.3","Z23","Z71.82","F32.A","F41.9","F90.1","F32.1","R11.0","S52.591","R45.86","F39","F90.2"],"date":["2026-08-19","2026-08-19","2026-08-02","2026-08-05","2026-08-01","2026-08-01","2026-08-01","2026-04-13","2026-04-13","2026-06-23","2026-05-07","2026-05-07","2026-05-07","2026-05-07","2026-05-07","2026-05-07","2026-07-31","2026-08-18","2026-08-18","2026-08-18","2026-06-23","2026-07-31","2026-07-31","2026-08-19"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","",""]}},"1":{"a":[]},"3":{"a":{"indx":["1",""],"comment":["",""],"sub":[]}}}},{"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":[["","","METHYLPHENIDATE HYDROCHLORIDE ER (OSM)","18000 MG","","Select","Select",""],["","","FLUOXETINE HYDROCHLORIDE","20000 MG","","Select","Select",""],["","","ESCITALOPRAM OXALATE","20000 MG","","Select","Select",""],["","","HYDROXYZINE PAMOATE","25000 MG","","Select","Select",""],["","","ARIPIPRAZOLE","5000 MG","","Select","Select",""],["","","SERTRALINE HYDROCHLORIDE","25000 MG","","Select","Select",""],["","","ONDANSETRON ODT","4000 MG","","Select","Select",""],["","","DESVENLAFAXINE ER","25000 MG","","Select","Select",""],["","","IBUPROFEN","600000 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":""}]}]}