{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joanne A Britton","gend":1,"currentgend":"","add":"79 BIGELOW RD","city":"LEBANON","state":"ME","zip":"04027","dob":"1947-11-02","age":"","mstatus":"","insh":"10000053620","cliId":"","pno":2073390293,"cno":"","email":"Joannebritton1102@gmail.com","ename":"","eno":"","pphy":"WOOD, LORI A","ppno":6037559801,"pcpadd":"PO BOX 412503,","pcpcity":"BOSTON","pcpstate":"MA","pcpzip":"22412503","pcpcounty":"","pcpid":"","pcpname":"WHP PRIMARY CARE OF ROCHESTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"79 BIGELOW RD","madd2":"","madd3":"","mcity":"LEBANON","mstate":"ME","mzip":"04027","pcpfaxno":6037559806,"pcpnpi":1831252410,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3J45CF0NQ74","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1142","D329","R32","I10","E1169","E785","R100","E1140","Z860100","Z538","E119","Z23","R413","Z1211","E6601","Z6841","Z961","R002","K219","M5450","G8929","K5730","M25511","K635","Z87891","Z83719","D125","R252","Z780","D649","D509","S31109A","R918","M65321","M19041","M19042","Z1231","M8588","F419","H26492","R6889","H35373","H5201","M549","Z0000"],"date":["2025-08-05","2024-11-05","2024-01-11","2024-11-18","2025-11-07","2024-09-09","2024-12-09","2024-03-07","2024-11-18","2024-10-21","2025-11-19","2025-11-14","2024-10-01","2024-11-18","2024-11-18","2024-11-18","2025-11-19","2023-04-18","2024-12-10","2023-04-18","2025-06-20","2024-12-09","2025-06-20","2024-11-18","2025-06-20","2024-11-18","2024-11-18","2023-09-11","2023-08-28","2023-08-28","2022-12-30","2024-04-01","2025-07-13","2025-03-12","2025-02-05","2025-02-05","2025-10-02","2024-04-18","2025-08-22","2022-11-03","2022-10-17","2022-09-30","2022-09-30","2022-07-29","2022-07-26"],"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":[["","","MELOXICAM","","","Select","Select",""],["","","ROPINIROLE HCL","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ACETAMINOPHEN-CODEINE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","MICROLET","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","","","Select","Select",""],["","","CONTOUR NEXT TEST STRIP","","","Select","Select",""],["","","PIOGLITAZONE HCL","","","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":{"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":""}]}]}