{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Samara M French","gend":1,"currentgend":"","add":"114 Emerald Dr SE","city":"Calhoun","state":"GA","zip":30701,"dob":"2024-03-28","age":"","mstatus":"","insh":"AS1004881002","cliId":"","pno":7065377223,"cno":"","email":"","ename":"","eno":"","pphy":"John Joyave","ppno":7066255900,"pcpadd":"204 PROFESSIONAL CT SE","pcpcity":"CALHOUN","pcpstate":"GA","pcpzip":30701,"pcpcounty":"","pcpid":"","pcpname":"204 PROFESSIONAL CT SE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"114 Emerald Dr SE","madd2":"","madd3":"","mcity":"Calhoun","mstate":"GA","mzip":30701,"pcpfaxno":7066255906,"pcpnpi":1649639907,"currentgendcomment":"","pphycomment":"","uniqueid":431608,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":{"0":{"a":{"diag":["P07.33","P70.4","R91.8","P22.9","M62.81","P22.0","Z91.89","Z05.1","P28.49","P52.22","Q25.6","Q21.20","P61.2","Q25.0","Q21.12","P29.12","Z23","P59.0","H35.123","P74.22","P09.8","P81.9","P08.1","P07.17","Z00.129","Z00.121","Z13.1","R62.50","H35.113","Q25.79","Z09","P84","Z13.88","Z46.59","Q75.3","Z38.00","R50.9","L08.9","L22"],"date":["2025-10-21","2024-03-28","2024-03-28","2024-03-30","2025-12-04","2024-05-10","2024-05-10","2024-05-10","2024-04-14","2024-03-28","2024-03-28","2024-03-28","2024-03-28","2024-03-28","2024-05-09","2024-03-28","2025-09-29","2024-04-07","2024-03-28","2024-03-28","2024-03-28","2024-03-28","2024-03-28","2024-03-28","2024-10-02","2025-09-29","2025-06-30","2026-02-05","2024-12-17","2024-08-28","2024-04-18","2024-03-28","2025-04-08","2024-03-28","2025-05-22","2024-03-28","2025-04-03","2025-04-03","2025-04-03"],"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":[["","","Mupirocin","0.02 MG","","Select","Select",""],["","","Cephalexin","50 MG","","Select","Select",""],["","","Ferrous Sulfate","75 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":""}]}]}