{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter J Guarino","gend":0,"currentgend":"","add":"80 HUBBARD RD","city":"BERWICK","state":"ME","zip":"03901","dob":"1951-04-21","age":"","mstatus":"","insh":"10000107616","cliId":"","pno":3038173054,"cno":"","email":"declined@042425.com","ename":"","eno":"","pphy":"WOOD, SARAH L","ppno":6038831626,"pcpadd":"207 S MAIN ST,","pcpcity":"NEWMARKET","pcpstate":"NH","pcpzip":"38571835","pcpcounty":"","pcpid":"","pcpname":"LAMPREY HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"80 HUBBARD RD","madd2":"","madd3":"","mcity":"BERWICK","mstate":"ME","mzip":"03901","pcpfaxno":6038161039,"pcpnpi":1184384000,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2WU1FK7AU99","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T83511A","N411","N3001","R339","N1339","N3000","R350","R351","Z9181","N1830","I10","N390","R300","H25812","H40012","H2589","H18513","H6122","N1330","N3289","R000","R9431","H2512","E782","A419","R531","R5383","R4182","R110"],"date":["2025-08-21","2025-04-17","2025-02-14","2025-09-12","2025-09-02","2025-09-02","2025-07-31","2025-07-31","2025-09-10","2025-08-28","2025-06-11","2025-08-23","2025-06-02","2025-08-06","2025-07-15","2025-07-15","2025-07-15","2025-08-28","2025-08-22","2025-08-22","2025-08-22","2025-08-25","2025-08-06","2025-03-03","2025-08-21","2025-08-21","2025-08-21","2025-08-21","2025-08-21"],"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":[["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","TELMISARTAN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","CHLORTHALIDONE","","","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":""}]}]}