{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Margaret A Rosenkrantz","gend":1,"currentgend":"","add":"3 TEMPY LN","city":"WAYNE","state":"ME","zip":"04284","dob":"1943-09-28","age":"","mstatus":"","insh":"10000078025","cliId":"","pno":2076858178,"cno":"","email":"marosenkrantz@aol.com","ename":"","eno":"","pphy":"IANTOSCA, AMANDA N","ppno":2073772111,"pcpadd":"789 CENTRAL AVE,","pcpcity":"DOVER","pcpstate":"NH","pcpzip":"38202526","pcpcounty":"","pcpid":"","pcpname":"WINTHROP FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2078645908,"add2":"","add3":"","madd1":"3 TEMPY LN","madd2":"","madd3":"","mcity":"WAYNE","mstate":"ME","mzip":"04284","pcpfaxno":2076243845,"pcpnpi":1598086241,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5EV4WD6PT09","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H02831","H02834","Z1231","I129","I10","Z23","Z0101","E113293","E113391","H4322","Z9841","R7301","M810","Z13820","E785","K5900","K5732","N179","N1831","N83292","R600","S30861A","W57XXXA","E876","R011","L400","Z0000","R34","I080","M8559","Z780","M8580","N83209","R10814","E118","Z9842","H903","Z461","R6889","H905","L820","L538","R208","L298"],"date":["2023-03-31","2023-03-31","2024-02-06","2025-01-09","2025-01-08","2025-10-17","2025-01-21","2025-01-21","2023-11-14","2023-11-14","2023-11-14","2023-10-23","2025-10-09","2025-05-19","2025-10-07","2024-10-29","2024-11-05","2024-11-15","2025-03-28","2024-11-01","2024-11-21","2023-05-20","2023-05-20","2024-11-01","2024-11-21","2023-10-17","2025-04-02","2024-10-28","2024-12-02","2025-05-19","2025-05-19","2023-10-25","2023-10-25","2024-10-29","2023-03-31","2022-10-26","2022-11-02","2022-11-02","2022-10-31","2022-10-19","2022-10-13","2022-10-13","2022-10-13","2022-10-13"],"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":[["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","VALSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FLUOCINONIDE","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}