{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gary L Bull","gend":0,"currentgend":"","add":"4408 White Birch Pt","city":"Gainesville","state":"GA","zip":"30506","dob":"1973-07-28","age":"","mstatus":"","insh":"AS9053980001","cliId":"","pno":"7706546526","cno":"7706546526","email":"gkbull@bellsouth.net","ename":"","eno":"","pphy":"Kelly Mackey","ppno":"7702199260","pcpadd":"73 MAXWELL LN","pcpcity":"DAHLONEGA","pcpstate":"GA","pcpzip":"30533","pcpcounty":"","pcpid":"","pcpname":"73 MAXWELL LN","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"4408 White Birch Pt","madd2":"","madd3":"","mcity":"Gainesville","mstate":"GA","mzip":"30506","pcpfaxno":"","pcpnpi":"1225101371","currentgendcomment":"","pphycomment":"","uniqueid":"290775","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":["C71.9","Z79.69","C71.1","Z08","Z85.841","R10.11","R74.01","G25.2","G40.909","K21.9","Z79.899","Z92.3","Z13.6","Z71.2","G40.109","I44.0","Z51.11","D70.1","T45.1X5","G93.89","T66.XXX","G93.6","Z01.818","R56.9"],"date":["2026-08-06","2026-08-04","2026-04-15","2026-03-30","2026-03-30","2026-04-16","2026-04-16","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-15","2026-04-16","2026-08-06","2026-08-06","2026-04-15","2026-06-10","2026-01-16","2026-01-16","2026-04-16","2026-05-08","2026-03-30","2026-04-14","2026-04-15"],"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":[["","","LEVOFLOXACIN","500000 MG","","Select","Select",""],["","","GLEOSTINE","10000 MG","","Select","Select",""],["","","DEXAMETHASONE","2000 MG","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","40000 MG","","Select","Select",""],["","","METHOCARBAMOL","500000 MG","","Select","Select",""],["","","MATULANE","50000 MG","","Select","Select",""],["","","LEVETIRACETAM","750000 MG","","Select","Select",""],["","","LACOSAMIDE","100000 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":""}]}]}