{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karen H James","gend":1,"currentgend":"","add":"6 LEVI LN UNIT 104","city":"BIDDEFORD","state":"ME","zip":"04005","dob":"1951-03-12","age":"","mstatus":"","insh":"10000056333","cliId":"","pno":2076026226,"cno":6037811062,"email":"KAREN.JAMES.207@GMAIL.COM","ename":"","eno":"","pphy":"MUNROE, CHRISTINE","ppno":2073849212,"pcpadd":"GREAT WORKS FAMILY PRACTICE,57 PORTLAND ST STE 2A","pcpcity":"SOUTH BERWICK","pcpstate":"ME","pcpzip":"03908","pcpcounty":"","pcpid":"","pcpname":"GREAT WORKS FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 LEVI LN UNIT 104","madd2":"","madd3":"","mcity":"BIDDEFORD","mstate":"ME","mzip":"04005","pcpfaxno":2073842008,"pcpnpi":1538369657,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3NN2X09CN99","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","M170","E6601","U071","Z0101","H524","H16223","D0371","M109","L720","D692","Z85828","M7120","M79605","J209","Z87891","D485","L570","L821","D1801","Z1283","Z08","Z1231","I10","Z0000","L578","M7122","Z1211","L928","Z23","Z8669","H903","Z20822"],"date":["2025-09-09","2025-05-30","2024-01-30","2023-06-05","2025-09-09","2025-09-09","2025-09-09","2025-05-14","2024-03-21","2023-11-29","2025-10-27","2023-11-29","2024-01-11","2024-01-04","2023-12-16","2024-01-04","2025-08-11","2025-10-27","2025-10-27","2025-10-27","2025-04-28","2025-04-28","2025-05-30","2025-11-03","2025-04-17","2025-10-27","2024-01-04","2024-10-12","2025-08-11","2022-10-06","2022-07-26","2022-07-28","2022-05-06"],"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":[["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","LISINOPRIL-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","PENICILLIN V POTASSIUM","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","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":""}]}]}