{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Denise A Alley","gend":1,"currentgend":"","add":"5 DAVIS LN","city":"MOUNT DESERT","state":"ME","zip":"04660","dob":"1961-09-24","age":"","mstatus":"","insh":"10000114769","cliId":"","pno":2072884298,"cno":"","email":"DECLINED@07312025.COM","ename":"","eno":"","pphy":"DELVECCHIO, ANGELA S","ppno":2072885119,"pcpadd":"Cadillac Family Practice,322 Main St","pcpcity":"Bar Harbor","pcpstate":"ME","pcpzip":"04609","pcpcounty":"","pcpid":"","pcpname":"CADILLAC FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5 DAVIS LN","madd2":"","madd3":"","mcity":"MOUNT DESERT","mstate":"ME","mzip":"04660","pcpfaxno":2072888449,"pcpnpi":1871689257,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6RN6UQ7CV84","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J3489","J309","E1010","G4733","E113593","R0681","K219","J329","R490","K118","E113393","Z1231","E1065","Z1239","Z7982","Z87891","Z0000","R9389"],"date":["2025-04-07","2025-03-25","2025-05-02","2025-03-11","2025-07-15","2024-10-17","2025-01-17","2025-01-17","2025-01-17","2024-06-21","2024-05-24","2025-06-23","2025-06-10","2024-06-18","2024-05-20","2024-05-20","2024-10-10","2024-07-08"],"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":[["","","TRUE METRIX GLUCOSE TEST STRIP","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","MOXIFLOXACIN HCL","","","Select","Select",""],["","","INSULIN GLARGINE SOLOSTAR","","","Select","Select",""],["","","OMNIPOD DASH PODS (GEN 4)","","","Select","Select",""],["","","INSULIN LISPRO KWIKPEN U-100","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","FIASP FLEXTOUCH","","","Select","Select",""],["","","GLUCAGON EMERGENCY KIT","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","TRESIBA","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","DEXCOM G6 SENSOR","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","RAMIPRIL","","","Select","Select",""],["","","TRESIBA FLEXTOUCH U-100","","","Select","Select",""],["","","DEXCOM G6 TRANSMITTER","","","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":{"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":{"indx":[],"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":""}]}]}