{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kearrie Heath","gend":1,"currentgend":"","add":"8 May St NW","city":"Rome","state":"GA","zip":"30165","dob":"1990-10-16","age":"","mstatus":"","insh":"AS9066321001","cliId":"","pno":"7067286566","cno":"7067286566","email":"kearrie1016@gmail.com","ename":"","eno":"","pphy":"Amanda Reeves","ppno":"7062339349","pcpadd":"123 THREE RIVERS DR NE","pcpcity":"ROME","pcpstate":"GA","pcpzip":"30161","pcpcounty":"","pcpid":"","pcpname":"123 THREE RIVERS DR NE","plan":"Alliant","program":"ACA","lob":"","region":"","aligned":"N","ano":"","add2":"","add3":"","madd1":"8 May St NW","madd2":"","madd3":"","mcity":"Rome","mstate":"GA","mzip":"30165","pcpfaxno":"7062327986","pcpnpi":"1285927491","currentgendcomment":"","pphycomment":"","uniqueid":"510974","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":["I42.1","D50.9","D75.839","D72.820","R11.0","R07.89","H53.149","R68.84","R06.02","D50.0","E11.9","Z79.4","R29.898","G89.29","M54.12","M54.41","E78.2","R53.83","E11.65","E53.8","I11.0","Z68.44","M51.362","E55.9","I27.20","I50.32","K76.0","E78.5","G47.33","Z79.82","Z79.84","Z79.899","H91.90","H54.7","G44.209","Z91.141","Z09","I1A.0","Z12.4","E61.1","Z86.2","I10","E11.42","E11.69","N92.1","N89.8","R51.9","H53.9","Z00.00","Z13.29","Z13.6","M47.22","R06.09","E66.01","R30.0","M51.86","N83.201","R07.9","M79.89","M79.662","R10.30","R10.23","N83.202","M54.16","Q21.0","D64.9","R39.89","N76.0","R31.0","R39.9","E11.36","H40.003","H25.13","R10.11","G47.26","R09.89","Z68.43","Z79.85","I16.0","I24.9","M48.02","M47.26","I50.30","G47.14","I27.21","M51.26","M48.061","M47.816","R07.2","I51.7","M54.50","R42","H53.8","R94.31"],"date":["2026-03-02","2026-04-29","2026-04-29","2026-04-29","2026-07-19","2026-07-19","2026-07-19","2026-07-19","2026-07-19","2026-07-19","2026-07-19","2026-07-19","2026-06-23","2026-06-24","2026-06-23","2026-06-23","2026-06-24","2026-06-10","2026-06-24","2026-06-24","2026-06-24","2026-06-08","2026-03-09","2026-06-24","2026-06-17","2026-06-24","2026-02-26","2026-02-26","2026-08-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-02-26","2026-06-09","2026-06-09","2026-06-09","2026-06-24","2026-01-28","2026-06-04","2026-04-29","2026-01-28","2026-01-28","2026-08-04","2026-07-18","2026-05-06","2026-04-29","2026-06-24","2026-06-24","2026-07-09","2026-06-08","2026-06-08","2026-08-04","2026-03-09","2026-08-06","2026-07-19","2026-08-06","2026-08-06","2026-08-06","2026-08-06","2026-08-06","2026-06-24","2026-01-12","2026-07-18","2026-08-04","2026-08-04","2026-08-04","2026-08-04","2026-02-23","2026-02-23","2026-02-23","2026-02-27","2026-04-02","2026-04-02","2026-05-06","2026-05-06","2026-03-02","2026-05-06","2026-07-09","2026-07-09","2026-03-02","2026-02-26","2026-02-26","2026-03-09","2026-03-09","2026-03-09","2026-02-28","2026-02-28","2026-03-08","2026-02-26","2026-02-26","2026-07-19"],"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":[["","","HYDROCHLOROTHIAZIDE","25000 MG","","Select","Select",""],["","","AMLODIPINE BESYLATE","10000 MG","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","10000 MG","","Select","Select",""],["","","LOSARTAN POTASSIUM","100000 MG","","Select","Select",""],["","","TRESIBA FLEXTOUCH","200000 UNIT\/ML","","Select","Select",""],["","","MOUNJARO","5000 MG\/0.5ML","","Select","Select",""],["","","HYDRALAZINE HYDROCHLORIDE","10000 MG","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCETS EXTRA FINE","0","","Select","Select",""],["","","SPIRONOLACTONE","25000 MG","","Select","Select",""],["","","BUTALBITAL\/ACETAMINOPHEN\/CAFFEINE","0","","Select","Select",""],["","","METHOCARBAMOL","500000 MG","","Select","Select",""],["","","PREDNISONE","20000 MG","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","10000 MG","","Select","Select",""],["","","DICLOFENAC SODIUM DR","75000 MG","","Select","Select",""],["","","SYMBICORT","0","","Select","Select",""],["","","FLUCONAZOLE","150000 MG","","Select","Select",""],["","","METRONIDAZOLE","500000 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":""}]}]}