{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Deborah A Anderson","gend":1,"currentgend":"","add":"206 PINE HILL RD","city":"BERWICK","state":"ME","zip":"03901","dob":"1940-08-29","age":"","mstatus":"","insh":"10000067277","cliId":"","pno":2076981602,"cno":"","email":"anderson_da@comcast.net","ename":"","eno":"","pphy":"LACOY, MARY BETH","ppno":"","pcpadd":"7 WORKS WAY,","pcpcity":"SOMERSWORTH","pcpstate":"NH","pcpzip":"38781639","pcpcounty":"","pcpid":"","pcpname":"WHP HILLTOP FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"206 PINE HILL RD","madd2":"","madd3":"","mcity":"BERWICK","mstate":"ME","mzip":"03901","pcpfaxno":8339442270,"pcpnpi":1871236026,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8H94RM4NU73","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R918","E042","C50911","R059","M5450","R911","M85852","D440","M8580","M810","N838","Z8673","H2511","R519","I10","E782","I6529","R29818","H538","I493","H539","M19032","H8190","Z1231","M8588","R7303","K219","R42","Z90710","H43813","H02403","H2512","E7800","M2550","H903","H25812","H9313","H25811","J984","M25572","R202","M5136","M1812","E785","H25813","R599","F419","H6593","Z23","M2170","M47816","S86812A","R300","R350","N760","G5792","N3001","B373","G5732","M7752","U071","M7732","M79672","Z780"],"date":["2025-11-10","2025-10-17","2024-10-08","2023-04-05","2023-02-01","2025-02-03","2023-10-27","2024-11-11","2023-10-30","2025-10-17","2025-01-06","2023-11-27","2024-03-14","2025-02-04","2025-02-04","2025-02-04","2023-12-20","2025-01-22","2025-01-22","2025-01-23","2025-01-23","2025-10-17","2024-01-30","2024-07-15","2024-07-11","2023-01-11","2023-01-11","2024-03-01","2025-01-02","2024-10-29","2024-10-29","2024-03-28","2024-03-28","2025-07-08","2024-03-01","2024-03-28","2024-03-01","2024-03-14","2024-11-11","2023-02-01","2023-02-01","2023-02-01","2025-10-17","2024-09-23","2024-02-02","2024-11-04","2024-11-04","2023-09-25","2022-10-27","2022-11-02","2022-09-21","2022-09-23","2022-09-08","2022-09-09","2022-09-09","2022-08-22","2022-08-20","2022-08-20","2022-07-27","2022-07-27","2022-07-16","2022-07-13","2022-07-13","2022-06-13"],"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",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","PRALUENT PEN","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","REPATHA SURECLICK","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","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":""}]}]}