{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Samuel M Munroe","gend":0,"currentgend":"","add":"876 SOKOKIS TRL","city":"NORTH WATERBORO","state":"ME","zip":"04061","dob":"1956-08-20","age":"","mstatus":"","insh":"10000104859","cliId":"","pno":2072064873,"cno":"","email":"","ename":"","eno":"","pphy":"MEADOWS, RHIANNA M","ppno":"","pcpadd":"840 E MCKELLIPS RD,SUITE 101","pcpcity":"MESA","pcpstate":"AZ","pcpzip":"85203964","pcpcounty":"","pcpid":"","pcpname":"NASSON HEALTH CARE NORTH BERWICK","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"876 SOKOKIS TRL","madd2":"","madd3":"","mcity":"NORTH WATERBORO","mstate":"ME","mzip":"04061","pcpfaxno":4808338313,"pcpnpi":1194988311,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6Q73AG8EX94","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E782","I10","R635","M9901","I6523","Z136","M47812","M542","Z122","M25561","E6601","Z87891","E039","R0601","Z1211","J449","E785","M62830","J441","Z23"],"date":["2025-03-05","2025-09-24","2024-04-30","2025-10-09","2025-09-30","2024-04-12","2025-09-26","2025-09-29","2025-06-29","2024-08-06","2024-08-06","2025-06-29","2025-09-24","2025-03-05","2025-07-01","2025-06-24","2023-10-18","2025-09-29","2023-05-12","2024-01-31"],"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":[["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","OLMESARTAN-AMLODIPINE-HCTZ","","","Select","Select",""],["","","TOPIRAMATE","","","Select","Select",""],["","","AMLODIPINE-OLMESARTAN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","OLMESARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}