{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Wayne A Sosebee","gend":0,"currentgend":"","add":"1343 Eastbrook Rd SE","city":"Dalton","state":"GA","zip":30721,"dob":"1964-03-21","age":"","mstatus":"","insh":"AS1006013002","cliId":"","pno":7069349728,"cno":7069349728,"email":"sosebee64@charter.net","ename":"","eno":"","pphy":"Lisa Duhaime","ppno":7062268950,"pcpadd":"1200 MEMORIAL DR","pcpcity":"DALTON","pcpstate":"GA","pcpzip":30720,"pcpcounty":"","pcpid":"","pcpname":"1200 MEMORIAL DR","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"1343 Eastbrook Rd SE","madd2":"","madd3":"","mcity":"Dalton","mstate":"GA","mzip":30721,"pcpfaxno":7062726836,"pcpnpi":1083697494,"currentgendcomment":"","pphycomment":"","uniqueid":195266,"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":["R00.2","R00.0","I11.0","I50.32","K21.9","Z87.891","Z79.01","Z79.899","Z48.89","L57.0","D23.9","L81.4","D22.9","Z85.820","I50.33","C43.9","I95.9","E66.01","Z68.41","I48.0","N40.0","G47.33","R73.03","I87.2","Z79.82","Z88.8","Z91.148","Z11.52","Z11.59","D48.5","R94.8","H61.21","H60.543","H91.90","I10","I27.20","I51.89","C43.72","J38.7","I48.91","I48.92","Z86.79","Z68.39","L72.3","I83.90","L85.9","Z00.00","E66.9","R73.9","R06.83","C43.59","M72.2","I48.19","Z51.81","N52.9","Z68.37","E87.6","H60.392","E03.9","R60.9","R20.2","M25.311","M75.101","Z98.890","Z12.5","R94.02","G57.52","H90.3","C13.9","M19.011","M25.511","L98.8","M12.811","D17.9","I21.9","I44.0","I45.4","Z01.818","I48.4","N40.1","R35.0","C43.62","D23.5","L81.8","R60.0","H60.332","H90.5","H61.22","D49.0","R93.89","I48.3","L72.0","L82.1","D22.5","J20.9","I49.3","Z23","L73.8","R06.09","R06.02","S82.832","I51.7","D03.59","S81.802","Z18.89","K14.8","J18.9","Z01.810","L08.89","L90.5","L08.9","I47.19","F32.A","B07.9","Z03.89","I50.9","I08.8","I31.39","I87.8","I45.9","Z12.11","Z12.12","I49.1","Z13.6","R06.00"],"date":["2024-05-20","2024-05-20","2026-02-09","2026-02-09","2025-12-29","2026-02-09","2026-01-19","2025-12-29","2025-06-09","2025-10-20","2025-10-20","2026-01-06","2026-01-06","2026-01-06","2025-12-04","2026-02-09","2025-11-03","2026-02-09","2025-12-04","2026-03-16","2026-02-04","2025-11-03","2026-03-02","2025-11-03","2025-11-03","2025-11-03","2025-11-03","2025-11-03","2025-11-03","2026-01-06","2026-01-28","2025-10-16","2026-01-28","2025-11-24","2026-03-16","2026-03-11","2026-03-11","2026-03-16","2026-02-09","2025-12-29","2024-05-21","2024-05-21","2025-06-02","2025-07-21","2026-01-06","2025-07-21","2025-12-04","2025-04-21","2025-06-02","2025-12-29","2025-04-21","2023-07-07","2026-01-19","2026-01-19","2026-03-02","2026-03-02","2026-02-20","2025-08-11","2026-03-16","2023-07-05","2023-07-05","2023-06-19","2023-06-19","2025-12-29","2025-12-04","2026-02-05","2025-10-28","2026-02-02","2026-02-25","2024-03-13","2024-03-13","2025-04-21","2023-04-27","2023-07-20","2025-11-04","2025-12-29","2025-11-05","2025-04-18","2024-06-06","2024-05-20","2024-05-20","2025-07-21","2025-07-21","2025-07-21","2025-12-04","2026-01-28","2026-01-28","2026-01-28","2026-01-28","2026-01-28","2024-05-21","2023-04-24","2023-04-24","2025-08-28","2025-06-02","2025-11-05","2025-12-04","2026-02-09","2024-05-20","2026-03-16","2023-05-10","2025-12-29","2025-04-21","2025-04-21","2026-01-06","2026-02-09","2025-03-27","2025-12-29","2025-10-28","2025-08-28","2025-08-28","2024-05-20","2024-05-20","2023-04-24","2024-05-21","2025-12-29","2025-11-03","2025-11-03","2025-11-03","2025-11-04","2026-01-12","2026-01-12","2025-04-16","2025-04-16","2024-05-20"],"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":[["","","Flecainide Acetate","100 MG","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","24 Hr Alfuzosin Hydrochloride","10 MG","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","Metoprolol Tartrate","25 MG","","Select","Select",""],["","","Clindamycin","10 MG","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Spironolactone","25 MG","","Select","Select",""],["","","Losartan Potassium","100 MG","","Select","Select",""],["","","Sulfamethoxazole","800 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Ofloxacin","","","Select","Select",""],["","","Aspirin Low Dose","","","Select","Select",""],["","","Mometasone Furoate","1 MG","","Select","Select",""],["","","Eliquis","5 MG","","Select","Select",""],["","","Amiodarone Hydrochloride","200 MG","","Select","Select",""],["","","Carvedilol","6.25 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","Prochlorperazine","10 MG","","Select","Select",""],["","","Hydrochlorothiazide","12.5 MG","","Select","Select",""],["","","Doxazosin","2 MG","","Select","Select",""],["","","Bisoprolol Fumarate","5 MG","","Select","Select",""],["","","Ibuprofen","800 MG","","Select","Select",""],["","","Famotidine","40 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","0.5 Ml Varicella Zoster Virus Glycoprotein E, Recombinant","0.1 MG","","Select","Select",""],["","","Abrysvo Vial With Diluent","","","Select","Select",""],["","","Mupirocin","","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Torsemide","20 MG","","Select","Select",""],["","","Ondansetron","8 MG","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","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":""}]}]}