{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kayla B Dean","gend":1,"currentgend":"","add":"203 Chickasaw Dr","city":"Cohutta","state":"GA","zip":30710,"dob":"1986-06-21","age":"","mstatus":"","insh":"AS9014080001","cliId":"","pno":7062804038,"cno":7062804038,"email":"Kbdean1110@gmail.com","ename":"","eno":"","pphy":"Quoc Nguyen","ppno":4047561368,"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":"203 Chickasaw Dr","madd2":"","madd3":"","mcity":"Cohutta","mstate":"GA","mzip":30710,"pcpfaxno":4047561313,"pcpnpi":1427510023,"currentgendcomment":"","pphycomment":"","uniqueid":353252,"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":["O24.112","O99.212","Z3A.26","O10.012","J96.01","G47.33","J18.9","I10","R79.89","E03.9","O13.3","Z3A.36","J20.9","E11.65","F41.8","Z79.84","Z79.85","E66.01","Z68.41","R07.0","B37.9","Z79.4","O24.113","O10.013","Z3A.33","N91.0","J02.9","R91.8","Z37.0","O24.12","O10.02","O76","O70.1","O99.284","O99.344","Z3A.38","E78.5","Z79.82","Z86.16","R11.0","O13.9","I82.90","O24.913","O10.913","O99.283","J84.89","D50.0","O10.93","O99.893","O90.81","O24.13","O99.345","F40.240","Z79.899","Z87.59","Z11.52","Z82.49","O36.63X","Z3A.37","E78.2","O99.213","Z3A.31","G47.9","Z3A.35","R05.1","R09.81","R50.9","J34.89","R94.31","I23.1","I45.19","R00.0","Z3A.22","J02.0","F41.9","R60.9","F32.A","J18.1","R09.02","Z3A.32","J84.116","F41.3","Z3A.34","J96.21","Z39.2","R03.0","J02.8","R06.02","Z20.822","Z3A.17","O09.513","E11.9","Z13.6","O14.05","O80","Z3A.30","O36.813","H10.022","I34.1","I35.8"],"date":["2024-01-09","2024-01-09","2024-01-09","2024-01-09","2025-03-09","2026-01-22","2025-03-09","2026-01-22","2024-04-11","2026-01-22","2024-03-22","2024-03-22","2025-03-09","2026-01-22","2025-03-09","2025-03-09","2025-03-09","2025-03-09","2025-03-09","2025-03-25","2025-03-25","2026-01-22","2024-03-29","2024-03-29","2024-03-01","2025-06-26","2025-11-26","2024-04-14","2024-04-03","2024-04-02","2024-04-02","2024-04-02","2024-04-02","2024-04-02","2024-04-02","2024-04-03","2024-04-02","2024-04-02","2024-04-02","2024-12-03","2024-01-31","2024-04-10","2024-03-22","2024-03-22","2024-03-22","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-04-07","2024-03-26","2024-03-29","2025-03-08","2024-03-12","2024-02-13","2024-08-12","2024-03-15","2025-03-03","2025-03-03","2025-03-03","2025-03-03","2024-04-08","2024-04-08","2025-03-11","2025-03-11","2023-12-12","2025-05-21","2024-04-15","2024-04-15","2024-04-15","2025-03-08","2025-03-08","2024-02-23","2024-06-21","2025-03-04","2024-03-08","2024-04-14","2024-04-14","2025-11-26","2025-11-26","2025-03-08","2024-04-07","2023-11-07","2024-03-29","2025-03-09","2025-03-11","2024-04-04","2024-04-03","2024-02-09","2024-02-09","2025-02-06","2024-04-07","2024-04-07"],"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":[["","","Jardiance","10 MG","","Select","Select",""],["","","Janumet 50-1,000 Mg Tablet","","","Select","Select",""],["","","Buspirone Hydrochloride","7.5 MG","","Select","Select",""],["","","Sertraline","100 MG","","Select","Select",""],["","","Dexcom G7 Receiver","","","Select","Select",""],["","","Janumet Xr 50-1,000 Mg Tablet","","","Select","Select",""],["","","24 Hr Venlafaxine","75 MG","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","Dextromethorphan Hydrobromide","3 MG","","Select","Select",""],["","","Nda021457 200 Actuat Albuterol","0.09 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Janumet Xr","","","Select","Select",""],["","","Azithromycin","500 MG","","Select","Select",""],["","","Ofloxacin","3 MG","","Select","Select",""],["","","Ozempic","","","Select","Select",""],["","","Lidocaine Viscous","","","Select","Select",""],["","","Fluconazole","100 MG","","Select","Select",""],["","","Feirza 1\/20","","","Select","Select",""],["","","Sucralfate","1000 MG","","Select","Select",""],["","","24 Hr Metformin Hydrochloride","500 MG","","Select","Select",""],["","","Mounjaro","","","Select","Select",""],["","","Lantus Solostar 100 Unit\/Ml","","","Select","Select",""],["","","Bd Uf Short Pen Needle 8Mmx31G","","","Select","Select",""],["","","Labetalol Hydrochloride","200 MG","","Select","Select",""],["","","Bd Uf Mini Pen Needle 5Mmx31G","","","Select","Select",""],["","","Humalog 100 Unit\/Ml Kwikpen","","","Select","Select",""],["","","Hydroxyzine Pam","25 MG","","Select","Select",""],["","","Lisinopril","5 MG","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Amoxicillin\/Clavulanate Potassium","","","Select","Select",""],["","","Benzonatate","200 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Amoxicillin","500 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":""}]}]}