{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Judith F Martin","gend":1,"currentgend":"","add":"220 STATE RD APT 112","city":"KITTERY","state":"ME","zip":"03904","dob":"1944-01-01","age":"","mstatus":"","insh":"10000082655","cliId":"","pno":2077032434,"cno":2073632452,"email":"jfmartin01@gmail.com","ename":"","eno":"","pphy":"Chenausky, Meghan C","ppno":"","pcpadd":"7 HOLLAND WAY FL 1,","pcpcity":"EXETER","pcpstate":"NH","pcpzip":"38332997","pcpcounty":"","pcpid":"","pcpname":"YORK FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"220 STATE RD APT 112","madd2":"","madd3":"","mcity":"KITTERY","mstate":"ME","mzip":"03904","pcpfaxno":6037750247,"pcpnpi":1619590247,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8H39H82YV00","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C50412","F411","I480","F03A4","Z0000","C50129","Z0101","H35363","Z1231","M810","M8588","Z780","M8589","I749","G3184","R6889","K5900","H52223","H532","H5504","B977","R87810","Z01419","F331","R419"],"date":["2025-01-20","2024-08-19","2025-01-23","2025-06-17","2025-02-24","2024-07-09","2024-06-17","2024-06-17","2024-07-01","2024-04-22","2024-04-22","2024-04-22","2024-04-22","2024-06-03","2023-10-30","2023-09-13","2023-10-25","2023-09-06","2023-09-06","2023-09-06","2023-09-12","2023-09-12","2022-06-17","2022-06-14","2022-06-14"],"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":[["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","AMOXICILLIN","","","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":""}]}]}