{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Frank R Johnson","gend":0,"currentgend":"","add":"22 PORCUPINE MOUNTAIN LN","city":"MACHIAS","state":"ME","zip":"04654","dob":"1949-10-09","age":"","mstatus":"","insh":"10000057514","cliId":"","pno":2072718498,"cno":"","email":"1949FRJ@gmail.com","ename":"","eno":"","pphy":"QUINN, JENNIFER L","ppno":2072552772,"pcpadd":"110 STONE ST,","pcpcity":"ONEIDA","pcpstate":"NY","pcpzip":"13421213","pcpcounty":"","pcpid":"","pcpname":"DOWN EAST HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"22 PORCUPINE MOUNTAIN LN","madd2":"","madd3":"","mcity":"MACHIAS","mstate":"ME","mzip":"04654","pcpfaxno":"","pcpnpi":1952670069,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1KT0RF5CF17","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01812","M1990","L0390","Z96642","L409","I10","Z8614","Z96649","Z86010","M25552","M1612","G8929","L0291","C61","Z01818","M169","M9901","M9903","M542","M5459","J34829","G4730","Z23","F419","D860","Z8546","N529","R5383","E291","J3489","M533","M5450","S335XXD","R6889","R21","G4733","R0683","Z1211","K635","J322","J310","H353132","D3132","H40013","H2513","J0190","D649","R12","R42","J0100","M47818","E785","L02213","M160","L988","N4830","L02212","F411","E871","L259","H00019","Z0001","L03311","Z0000","H524","A4902","L03313"],"date":["2025-02-25","2025-05-05","2025-08-20","2025-08-15","2023-08-15","2025-03-04","2025-08-26","2025-05-20","2023-04-12","2024-12-13","2025-04-07","2024-12-13","2022-11-22","2025-05-28","2025-04-01","2024-12-17","2024-11-12","2025-02-06","2024-11-12","2024-11-12","2025-07-11","2025-07-11","2023-09-28","2022-11-07","2023-12-22","2025-01-28","2025-05-28","2025-05-28","2025-05-28","2025-08-11","2024-06-28","2024-07-25","2025-02-06","2023-10-10","2025-08-05","2025-07-08","2025-07-08","2023-04-12","2023-04-12","2025-04-30","2025-06-12","2024-10-01","2024-10-01","2024-10-01","2024-10-01","2024-09-24","2025-03-04","2022-11-07","2025-03-14","2024-09-10","2024-05-29","2025-03-14","2022-11-22","2024-11-13","2022-11-07","2025-06-05","2022-11-10","2023-08-15","2024-04-09","2024-04-09","2023-12-22","2023-08-09","2025-08-15","2025-04-24","2023-02-16","2022-08-22","2022-07-29"],"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":[["","","CITALOPRAM HBR","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","ACETAMINOPHEN-CODEINE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CEFACLOR","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","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":""}]}]}