{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"PATRICIA A WILKINS","gend":1,"currentgend":"","add":"34 CROSS RD","city":"MONT VERNON","state":"NH","zip":"03057","dob":"1954-11-04","age":"","mstatus":"","insh":10000092301,"cliId":"","pno":6032580069,"cno":"","email":"","ename":"","eno":"","pphy":"MOZUMDER, MOUSHUMI","ppno":6036733014,"pcpadd":"St Joseph Hospital Family Medicine and Specialty S,444 NASHUA ST","pcpcity":"MILFORD","pcpstate":"NH","pcpzip":"03055","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH HOSPITAL FAMILY MEDICINE AND SPECIALTY S","plan":"Martin's Point","program":"Medicare","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"34 CROSS RD","madd2":"","madd3":"","mcity":"MONT VERNON","mstate":"NH","mzip":"03057","pcpfaxno":"","pcpnpi":1841455011,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4YE1UX4NA22","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S42232D","M1711","I10","Z0000","E785","E6601","H2511","Z961","Z1231","Z1211","S1016XA","R21","W57XXXA","S42295A","S42292A","S42212A","W19XXXA","S42232A","M5450","J4520","S0990XS","G44211","H524"],"date":["2024-10-08","2024-12-10","2024-12-16","2024-12-16","2023-12-13","2024-04-12","2024-02-26","2024-02-26","2024-04-12","2024-05-06","2024-05-13","2024-05-13","2024-05-13","2024-07-12","2024-07-12","2024-07-08","2024-07-08","2024-07-23","2022-07-20","2023-02-09","2022-12-09","2023-02-13","2023-02-13"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","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":{"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":""}]}]}