{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Patricia L Frey","gend":1,"currentgend":"","add":"17 KINGS ROAD APT A","city":"York","state":"ME","zip":"03909","dob":"1953-11-11","age":"","mstatus":"","insh":"10000066073","cliId":"","pno":2074756904,"cno":"","email":"Tfrey53@hotmail.com","ename":"","eno":"","pphy":"ROBINSON, ELISABETH S","ppno":6034316677,"pcpadd":"Whole Life Health Care,100 Shattuck Way Suite 100","pcpcity":"Newington","pcpstate":"NH","pcpzip":"03801","pcpcounty":"","pcpid":"","pcpname":"WHOLE LIFE HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"17 KINGS ROAD APT A","madd2":"","madd3":"","mcity":"York","mstate":"ME","mzip":"03909","pcpfaxno":6036102232,"pcpnpi":1255421194,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6YJ2D20DX04","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0189","E278","Z859","Z111","R6889","M79671","D649","E790","N1831","I10","N250","Z8589","M25562","D3501","I350","Z01810","M8589","S42241D","S42201A","Z0000","M1712","M810","N1830","S42221K","K631","Z86010","D4411","H8110","D860","J8410","R918","Z0184","E785","E559","R944","R739","Z1231","S42221P","M87121","R590","Z0100","S42221D","S46211A","S42211D","R9389","L570","L814","D225","L821","C562","E279","N2581","S42291A","S43031A","R296","K9171","D862","R935","K2289","K449","I888","I898","D861","L989","Z8616","J9811","Z8543","M79601","S42241A","M13171","Z1211","D122","D123","D124","M109","N281","D4410","Z4789","R059","H6593","M7501","K6389","K668","K7689","R051","K621","M1009","Z860101","D120","D125","K5720","D3500","N189","Z23","J209","L578","Z1283","Z1212","E781"],"date":["2023-12-29","2024-01-31","2023-12-29","2024-02-27","2023-06-23","2022-12-14","2023-11-28","2025-10-17","2025-11-13","2025-10-17","2025-10-17","2023-12-28","2025-04-11","2024-01-03","2025-06-26","2023-12-14","2024-12-06","2025-07-24","2024-10-06","2025-04-07","2023-08-22","2024-12-06","2023-08-18","2025-05-22","2023-08-04","2023-08-04","2023-11-01","2025-02-02","2025-07-03","2025-07-03","2025-07-03","2024-09-16","2024-04-08","2024-04-03","2023-05-05","2025-04-08","2025-07-03","2025-07-24","2025-07-24","2024-02-20","2025-02-21","2025-04-11","2025-04-11","2025-04-11","2023-05-16","2025-07-10","2025-07-10","2025-07-10","2025-07-10","2023-10-11","2023-07-19","2023-06-09","2024-10-06","2024-10-06","2024-10-06","2023-07-19","2025-07-21","2024-02-20","2024-02-20","2024-02-20","2024-02-20","2024-02-22","2025-04-25","2025-04-25","2025-04-07","2023-08-03","2023-08-03","2024-10-08","2024-10-07","2024-01-28","2025-06-17","2023-07-18","2025-06-17","2023-07-18","2023-11-18","2024-05-29","2023-11-06","2024-11-15","2024-06-25","2024-06-25","2025-02-12","2023-07-19","2023-07-19","2023-07-19","2024-06-21","2023-07-18","2022-12-14","2025-06-17","2025-06-17","2025-06-17","2023-07-26","2023-07-26","2023-11-17","2022-10-20","2022-09-19","2022-03-17","2022-03-17","2022-03-15","2022-03-08"],"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":[["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","VALSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","MORPHINE SULFATE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FENOFIBRATE","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","OXYCODONE 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":{"indx":[["","","",""],[""],[""],[""],[""]],"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":""}]}]}