{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jessica A Tysen","gend":1,"currentgend":"","add":"13 CHESTNUT ST","city":"HALLOWELL","state":"ME","zip":"04347","dob":"1950-02-20","age":"","mstatus":"","insh":"10000058640","cliId":"","pno":2076210296,"cno":2076310197,"email":"","ename":"","eno":"","pphy":"MURRAY JAMES, NATHAN R","ppno":2076260606,"pcpadd":"Hallowell Family Practice,9 Union St","pcpcity":"Hallowell","pcpstate":"ME","pcpzip":"04347","pcpcounty":"","pcpid":"","pcpname":"HALLOWELL FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"13 CHESTNUT ST","madd2":"","madd3":"","mcity":"HALLOWELL","mstate":"ME","mzip":"04347","pcpfaxno":2076260022,"pcpnpi":1851376065,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5GC7KY7RF64","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S0101XA","S0990XA","I6782","R9089","D649","E785","R42","I4891","D509","D500","R739","Z0000","I10","M109","K449","S299XXA","R918","Z1231","R92323","R58","W19XXXA","S12401A","K922","D6832","T45515A","Z7182","Z713","M810","K5900","Z23","T189XXA","Z20822","S12400A","S12300A","S12200A","R200","D122","R7309","K2950","W1830XA","M5030","M47812","R55","Y92009","F1020","M7981","I480","I471"],"date":["2023-02-12","2023-01-31","2023-01-31","2023-01-31","2025-01-07","2025-09-08","2024-06-04","2025-02-11","2024-07-08","2025-05-13","2025-09-08","2025-09-10","2025-03-10","2023-06-29","2023-01-31","2023-01-31","2023-01-31","2025-10-11","2025-10-11","2023-01-31","2023-02-01","2023-02-14","2024-06-07","2024-06-05","2024-06-05","2025-09-10","2025-09-10","2023-07-05","2024-06-19","2025-09-10","2024-06-19","2023-01-31","2023-02-01","2023-02-01","2023-02-01","2023-02-01","2024-06-07","2024-07-09","2024-06-06","2023-02-12","2023-01-31","2023-01-31","2023-02-01","2023-02-01","2023-02-14","2023-02-14","2022-09-07","2022-09-07"],"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":[["","","XARELTO","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","ENALAPRIL MALEATE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL HFA","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","IBANDRONATE SODIUM","","","Select","Select",""],["","","ADVAIR HFA","","","Select","Select",""],["","","FOSAMAX","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}