{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karl Swanson","gend":0,"currentgend":"","add":"25 DEBRA LN","city":"KITTERY","state":"ME","zip":"03904","dob":"1950-01-21","age":"","mstatus":"","insh":"10000063497","cliId":"","pno":6175048822,"cno":"","email":"k1swanson@aol.com","ename":"","eno":"","pphy":"SHUMAN, JOLENE J","ppno":6036924018,"pcpadd":"Salmon Falls Family Healthcare,7 Works Way","pcpcity":"Somersworth","pcpstate":"NH","pcpzip":"03878","pcpcounty":"","pcpid":"","pcpname":"WHP PRIMARY CARE OF ROCHESTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"25 DEBRA LN","madd2":"","madd3":"","mcity":"KITTERY","mstate":"ME","mzip":"03904","pcpfaxno":6036921083,"pcpnpi":1407831910,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3VV1XG3UJ02","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z7901","I82409","E669","Z6836","Z86718","N1830","N1831","D649","R809","Z48815","I10","N250","Z1211","G4733","I429","Z23","E782","E039","E6601","N261","R944","Z9884","R7303","Z125","Z13220","Z86010","N281","Z136"],"date":["2025-10-15","2023-02-21","2024-09-10","2024-09-10","2025-10-14","2024-02-14","2025-09-08","2025-09-08","2025-09-08","2024-04-16","2025-09-12","2024-02-14","2023-09-18","2023-12-28","2023-01-19","2023-08-08","2025-03-05","2025-03-05","2025-03-05","2024-02-14","2023-08-17","2024-06-11","2024-02-14","2023-08-03","2023-08-03","2023-09-18","2022-10-11","2022-08-02"],"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":[["","","WARFARIN SODIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ZEPBOUND","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","SHINGRIX","","","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":""}]}]}