{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peggy Curtin","gend":1,"currentgend":"","add":"2113 Imperial Dr","city":"Gainesville","state":"GA","zip":30501,"dob":"1961-09-27","age":"","mstatus":"","insh":"AS1003841001","cliId":"","pno":6783161576,"cno":6783161576,"email":"peggymcurtin@gmail.com","ename":"","eno":"","pphy":"Margaret Davis","ppno":6782074373,"pcpadd":"725 JESSE JEWELL PKWY SE","pcpcity":"GAINESVILLE","pcpstate":"GA","pcpzip":305013834,"pcpcounty":"","pcpid":"","pcpname":"725 JESSE JEWELL PKWY SE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"2113 Imperial Dr","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":30501,"pcpfaxno":7705334727,"pcpnpi":1811989411,"currentgendcomment":"","pphycomment":"","uniqueid":247302,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D68.61","D89.89","Z01.419","Z12.11","Z13.31","D68.51","R92.30","Z68.23","R07.89","I10","Z87.891","M47.816","R13.10","R74.8","Z80.0","E86.0","E78.89","M54.12","M96.1","M46.1","E78.5","D68.52","Z79.01","Z51.81","Z68.24","E55.9","E53.8","D22.5","L82.1","L57.8","B00.1","Z87.2","Z09","R92.2","R63.4","Z68.21","F41.9","K21.00","R82.90","N39.0","M35.9","M32.19","E03.9","Z11.1","M05.79","R76.8","R68.2","B19.9","R07.9","K22.89","L29.2","R47.02","Z13.828","Z12.31","R31.9","L81.4","S90.112","L82.0","L53.8","L29.8","D48.5","Z79.891","R19.7","R11.0","I11.9","R63.30","H02.88A","H02.88B","Z96.1","Z98.890","H52.4","K12.1","K14.0","K14.6","L21.8","L73.8","L57.0","R30.0","Z29.9","H04.129","R63.0","R39.9","R43.2","K13.79","H04.123","J40","K21.9","R05.9","M48.061","M51.26","M51.36","M47.817","D22.39","Z78.0","I49.3","R00.2","E78.00","Z87.898","Z86.718"],"date":["2023-07-12","2023-07-12","2025-05-14","2025-05-14","2024-04-23","2025-11-23","2024-06-11","2024-11-08","2025-11-23","2025-11-23","2025-11-23","2025-12-17","2023-11-20","2023-11-20","2023-11-20","2023-08-07","2023-06-06","2026-02-11","2025-01-15","2026-02-11","2025-05-08","2023-03-22","2023-03-22","2025-12-17","2025-05-14","2025-03-07","2023-08-17","2025-05-08","2025-05-08","2025-06-25","2024-05-02","2025-05-08","2025-05-08","2024-06-11","2023-07-17","2023-08-07","2024-02-27","2024-02-27","2023-07-12","2023-08-07","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2023-08-01","2023-07-12","2025-11-22","2023-08-24","2025-05-14","2023-08-16","2023-04-19","2025-03-26","2023-08-07","2023-03-09","2023-03-09","2023-03-09","2023-03-09","2023-03-09","2025-05-08","2025-12-17","2024-11-08","2024-11-08","2024-11-08","2023-04-25","2026-02-26","2026-02-26","2026-02-26","2023-06-08","2026-02-26","2023-05-08","2023-05-08","2023-05-08","2025-06-25","2025-06-25","2025-06-25","2023-08-02","2023-08-02","2023-08-01","2023-08-01","2023-08-11","2023-08-16","2023-07-06","2026-02-26","2025-03-12","2023-05-17","2023-04-25","2024-09-07","2024-09-07","2024-09-07","2024-09-07","2023-03-09","2024-03-20","2023-05-17","2023-05-17","2023-05-17","2023-05-17","2023-05-17"],"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":[["","","Phenazopyridine Hydrochloride","200 MG","","Select","Select",""],["","","Rivaroxaban","20 MG","","Select","Select",""],["","","Solifenacin Succinate","10 MG","","Select","Select",""],["","","Rosuvastatin Calcium","20 MG","","Select","Select",""],["","","Chlorhexidine 0.12% Rinse","","","Select","Select",""],["","","Pilocarpine Hcl","5 MG","","Select","Select",""],["","","Nystatin 100000 Unt\/Ml Oral Suspension","","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Cefuroxime","500 MG","","Select","Select",""],["","","24 Hr Metoprolol Succinate","25 MG","","Select","Select",""],["","","Hydrocodone-Acetamin 7.5-325","","","Select","Select",""],["","","Cevimeline Hcl","30 MG","","Select","Select",""],["","","Diazepam","5 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","72 Hr Scopolamine","0.0139 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Ciprofloxacin","500 MG","","Select","Select",""],["","","Alprazolam","0.25 MG","","Select","Select",""],["","","Cholestyramine Resin","4000 MG","","Select","Select",""],["","","Hydrocodone\/Acetaminophen","","","Select","Select",""],["","","Triazolam","0.25 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Citalopram","20 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Trazodone Hydrochloride","50 MG","","Select","Select",""],["","","Nitrofurantoin, Macrocrystals","25 MG","","Select","Select",""],["","","Cevimeline Hydrochloride","30 MG","","Select","Select",""],["","","Enoxaparin","60 MG","","Select","Select",""],["","","Valacyclovir","1000 MG","","Select","Select",""],["","","Amoxicillin","875 MG","","Select","Select",""],["","","{6 Azithromycin","250 MG","","Select","Select",""],["","","Mometasone Furoate","","","Select","Select",""],["","","Nystatin 100000 Unt\/Ml \/ Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Pantoprazole Sodium","","","Select","Select",""],["","","Escitalopram","5 MG","","Select","Select",""],["","","Zolpidem Tartrate","10 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":""}]}]}