{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Irene Mickens-Mitchell","gend":1,"currentgend":"","add":"889 Egg and Butter Rd N","city":"Ochlocknee","state":"GA","zip":31773,"dob":"1975-08-23","age":"","mstatus":"","insh":"AS9032396001","cliId":"","pno":2294138399,"cno":2294138399,"email":"mitchellirene100@aol.com","ename":"","eno":"","pphy":"Kelly Ledger","ppno":2295510083,"pcpadd":"915 GORDON AVE","pcpcity":"THOMASVILLE","pcpstate":"GA","pcpzip":31792,"pcpcounty":"","pcpid":"","pcpname":"915 GORDON AVE","plan":"Alliant","program":"ACA","lob":"2026-Wave-1","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"889 Egg and Butter Rd N","madd2":"","madd3":"","mcity":"Ochlocknee","mstate":"GA","mzip":31773,"pcpfaxno":"","pcpnpi":1649543497,"currentgendcomment":"","pphycomment":"","uniqueid":463156,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R53.1","E55.9","G93.32","Z79.899","R94.5","Z01.89","M1A.39X","D50.9","K90.9","G47.19","J84.9","I27.21","R10.30","B02.9","R11.0","I82.412","J06.9","E66.3","Z68.27","I25.2","M32.9","K21.9","L03.116","I27.20","Z13.1","I10","I25.10","E78.2","I42.8","I50.32","R60.0","R74.8","L98.9","N18.31","B02.29","R73.03","I11.0","M54.6","G89.29","Z68.28","I25.118","I21.4","I42.9","I45.10","I51.7","I34.0","I36.1","R00.0","E78.00","J84.89","I50.42","I50.20","I27.22","M32.19","M17.0","R06.09","Z86.711","E66.09"],"date":["2026-01-15","2026-01-15","2026-01-15","2026-01-15","2026-01-15","2026-01-15","2026-01-15","2026-01-15","2026-01-15","2026-02-17","2026-02-17","2026-02-17","2025-07-01","2025-07-01","2025-07-01","2025-04-11","2025-11-17","2025-11-17","2025-11-17","2026-02-04","2025-10-20","2025-04-04","2025-04-04","2026-01-15","2025-04-04","2026-02-04","2026-01-15","2025-04-04","2026-02-04","2026-01-22","2025-07-18","2025-07-18","2025-07-18","2025-07-18","2025-07-18","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2025-10-20","2026-02-04","2025-04-08","2025-08-04","2025-04-08","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2026-02-04","2025-02-27","2026-02-04","2026-02-04","2026-02-04","2026-01-15","2026-01-15","2026-01-15","2026-01-15","2025-08-04"],"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":[["","","Amlodipine","5 MG","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","Pantoprazole Sodium","","","Select","Select",""],["","","Potassium Chloride","10 MEQ","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Tramadol Hydrochloride","","","Select","Select",""],["","","Hydroxychloroquine Sulfate","200 MG","","Select","Select",""],["","","Entresto","","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Triamcinolone Acetonide","1 MG","","Select","Select",""],["","","Torsemide","20 MG","","Select","Select",""],["","","Metoprolol Tartrate","50 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Valacyclovir","1000 MG","","Select","Select",""],["","","Pregabalin","75 MG","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","Sacubitril\/Valsartan","","","Select","Select",""],["","","Symbicort","","","Select","Select",""],["","","Albuterol Sulfate Hfa","","","Select","Select",""],["","","Finerenone","10 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Tizanidine","4 MG","","Select","Select",""],["","","Promethazine Dm","","","Select","Select",""],["","","Microencapsulated Potassium Chloride","20 MEQ","","Select","Select",""],["","","Mycophenolate Mofetil","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":""}]}]}