{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Janet L Smith","gend":1,"currentgend":"","add":"638 UPPER GUINEA RD","city":"LEBANON","state":"ME","zip":"04027","dob":"1957-11-16","age":"","mstatus":"","insh":"10000100533","cliId":"","pno":6033433439,"cno":"","email":"Jbay3439@gmail.com","ename":"","eno":"","pphy":"REALL, DAVID","ppno":"","pcpadd":"27 NEW DURHAM RD,","pcpcity":"ALTON","pcpstate":"NH","pcpzip":"38094917","pcpcounty":"","pcpid":"","pcpname":"ALTON FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"638 UPPER GUINEA RD","madd2":"","madd3":"","mcity":"LEBANON","mstate":"ME","mzip":"04027","pcpfaxno":"","pcpnpi":1891853412,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9KN7X48QK37","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I129","N182","E782","K580","R194","R197","M1711","M19072","M2042","R928","H2511","F17210","E7849","R195","I10","H25811","H35342","H25812","Z1231","M2022","M79672","L84","Z86010","Z23","Z1159","Z131","N6313","N62","E878"],"date":["2024-07-24","2025-02-03","2025-02-03","2025-02-03","2025-09-25","2025-09-25","2025-09-30","2025-05-21","2025-05-21","2023-03-28","2025-11-11","2023-05-17","2023-05-17","2023-05-18","2023-07-11","2025-11-11","2025-10-15","2025-11-18","2025-03-24","2025-05-22","2025-05-21","2025-04-09","2024-08-15","2023-01-11","2023-01-14","2023-01-14","2023-04-03","2023-04-03","2024-08-19"],"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":[["","","CHOLESTYRAMINE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","HYDROXYZINE PAMOATE","","","Select","Select",""],["","","LISINOPRIL-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","COLESTIPOL 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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}