{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rachel P Bossie","gend":1,"currentgend":"","add":"9 POND VIEW DR","city":"Turner","state":"ME","zip":"04282","dob":"1948-06-19","age":"","mstatus":"","insh":"10000026603","cliId":"","pno":2072247272,"cno":"","email":"Rbossie48@gmail.com","ename":"","eno":"","pphy":"WALL, JEFFREY A","ppno":2077847388,"pcpadd":"190 STETSON RD,","pcpcity":"AUBURN","pcpstate":"ME","pcpzip":"42107813","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"9 POND VIEW DR","madd2":"","madd3":"","mcity":"Turner","mstate":"ME","mzip":"04282","pcpfaxno":2077952043,"pcpnpi":1447288808,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9HC9NJ2AR23","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R252","R1084","R040","R3129","N329","M25561","Z0101","H401131","H25813","D3142","C679","G43B1","Z0000","E785","M810","K2210","M5417","Z1239","Z1211","R21","K5732","R319","Z713","K219","R5383","R6889","R10814","Z1231","R1032","K5792","Z01818","H2189","K449","K5730","N281","Z01812","F349","H409","K121","J029","Z85038","Z86010","R070"],"date":["2025-05-27","2025-03-20","2023-06-09","2025-04-16","2025-04-16","2024-01-25","2024-07-01","2025-06-27","2024-07-01","2024-07-01","2025-08-29","2023-09-19","2025-05-05","2025-05-05","2024-04-22","2024-04-22","2024-03-13","2025-05-05","2025-05-05","2025-05-27","2025-03-20","2025-05-02","2023-04-19","2023-04-17","2023-12-07","2023-11-08","2025-04-01","2025-06-25","2025-04-07","2025-04-07","2023-04-21","2025-06-27","2023-04-12","2025-03-20","2025-03-20","2025-05-07","2022-10-14","2022-10-14","2022-09-21","2022-09-21","2022-09-13","2022-09-13","2022-09-19"],"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":[["","","SERTRALINE HCL","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","TRAVOPROST","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","GAVILYTE-C","","","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":""}]}]}