{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lorrie Robertson","gend":1,"currentgend":"","add":"1114 McClure Dr","city":"Tunnel Hill","state":"GA","zip":30755,"dob":"1979-05-26","age":"","mstatus":"","insh":"AS9033468002","cliId":"","pno":7068476965,"cno":"","email":"","ename":"","eno":"","pphy":"Ektaben Patel","ppno":7062726000,"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":"1114 McClure Dr","madd2":"","madd3":"","mcity":"Tunnel Hill","mstate":"GA","mzip":30755,"pcpfaxno":"","pcpnpi":1801478797,"currentgendcomment":"","pphycomment":"","uniqueid":210292,"medicareid":"","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R91.8","R60.0","I50.33","J18.9","J96.21","J96.22","E87.3","E88.819","Z68.44","J44.0","D69.59","E03.9","I73.9","K75.81","J45.41","E66.813","D75.1","F17.210","F41.1","J96.12","J44.9","J44.1","Z13.1","Z13.31","J96.01","K74.60","I50.9","Z68.43","I11.0","M06.9","G89.29","G47.33","Z11.52","Z87.442","Z79.899","Z79.890","M25.561","M54.17","G90.521","M05.9","K74.69","K86.89","M79.671","I51.7","I36.1","G90.522","R07.9","H10.023","H57.89","Z76.0","J81.1","M79.672","I50.812","J30.2","J98.11","E66.01","I10","G57.61","R94.31","I42.2","Z13.6","G56.03","Z51.81","Z79.891","K76.89","I49.8","R10.9"],"date":["2025-12-16","2025-12-16","2025-12-30","2025-10-24","2025-12-30","2025-12-30","2025-10-19","2025-10-19","2025-10-19","2025-12-16","2025-10-19","2025-12-21","2025-10-19","2026-01-05","2025-10-24","2025-12-21","2025-10-19","2025-12-16","2025-11-03","2026-01-28","2026-01-28","2026-01-05","2025-10-13","2025-10-13","2025-12-21","2025-12-21","2025-12-16","2025-12-21","2025-12-16","2025-12-16","2025-12-16","2025-12-16","2025-12-16","2025-12-16","2025-12-16","2025-12-16","2026-03-02","2026-03-02","2026-03-02","2026-03-02","2026-01-05","2026-01-05","2025-09-15","2025-10-19","2025-10-19","2025-04-29","2025-12-16","2025-07-19","2025-07-19","2025-07-19","2025-10-18","2025-04-24","2025-12-05","2025-12-05","2025-12-16","2025-06-03","2025-06-03","2025-06-03","2025-12-17","2025-12-17","2025-12-17","2025-04-29","2025-12-08","2025-12-08","2025-10-22","2025-10-19","2025-12-18"],"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":[["","","Cyclobenzaprine Hydrochloride","10 MG","","Select","Select",""],["","","Levothyroxine Sodium","0.1 MG","","Select","Select",""],["","","Acetaminophen","325 MG","","Select","Select",""],["","","Levofloxacin","500 MG","","Select","Select",""],["","","Omeprazole","40 MG","","Select","Select",""],["","","Lorazepam","0.5 MG","","Select","Select",""],["","","Albuterol","0.833 MG","","Select","Select",""],["","","Azelastine Hydrochloride","0.137 MG","","Select","Select",""],["","","Oxycodone Hydrochloride","5 MG","","Select","Select",""],["","","Prednisolone Acetate","","","Select","Select",""],["","","{21 Methylprednisolone","4 MG","","Select","Select",""],["","","Budesonide\/Formoterol Fumarate Dihydrate","","","Select","Select",""],["","","Furosemide","40 MG","","Select","Select",""],["","","Ventolin Hfa","","","Select","Select",""],["","","24 Hr Desvenlafaxine Succinate","50 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":""}]}]}