{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Brenda L Badger","gend":1,"currentgend":"","add":"1174 ATHENS RD","city":"HARTLAND","state":"ME","zip":"04943","dob":"1950-01-22","age":"","mstatus":"","insh":"10000040443","cliId":"","pno":2079384206,"cno":"","email":"declined@110419.com","ename":"","eno":"","pphy":"DICRANIAN, WENDY R","ppno":2078584844,"pcpadd":"PO BOX 468,","pcpcity":"SKOWHEGAN","pcpstate":"ME","pcpzip":"49760468","pcpcounty":"","pcpid":"","pcpname":"SOMERSET PRIMARY CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1174 ATHENS RD","madd2":"","madd3":"","mcity":"HARTLAND","mstate":"ME","mzip":"04943","pcpfaxno":2078580348,"pcpnpi":1447287883,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7ND0C08GR34","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E785","M25531","Z1231","I2510","F419","I10","I350","I4589","H20042","Z0100","R739","Z0000","Z48812","Z006","E6601","Z98890","R0602","Z23","K529","H6121","Z952","R3129","M1711","D649","I080","I252","Z7982","Z87891","Z8249","L84","R6889","R197","I480","I4891","E119","I214","I083","I2584","R079","F418"],"date":["2024-04-24","2024-01-12","2024-08-19","2025-10-14","2025-07-07","2025-06-02","2024-10-17","2023-11-22","2023-11-27","2025-06-11","2023-02-02","2025-01-30","2023-05-05","2023-10-18","2023-10-18","2023-11-14","2023-08-30","2024-11-05","2025-06-29","2024-01-31","2025-10-08","2025-06-09","2023-08-02","2023-10-24","2023-07-21","2023-07-21","2023-08-30","2023-08-30","2023-08-30","2023-02-15","2022-12-19","2025-06-30","2024-10-25","2023-10-19","2024-04-30","2022-10-22","2022-10-21","2022-10-21","2022-10-20","2022-08-01"],"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":[["","","CARVEDILOL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ATENOLOL","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}