{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rebecca Mcchesney","gend":1,"currentgend":"","add":"5 GOULD LN","city":"Berwick","state":"ME","zip":"03901","dob":"1955-06-07","age":"","mstatus":"","insh":"10000118924","cliId":"","pno":8457178597,"cno":"","email":"rebeccarabbit423@gmail.com","ename":"","eno":"","pphy":"STEVENS, MICHAEL J","ppno":6037750000,"pcpadd":"7 HOLLAND WAY FL 1,","pcpcity":"EXETER","pcpstate":"NH","pcpzip":"38332997","pcpcounty":"","pcpid":"","pcpname":"CORE PRIMARY CARE PORTSMOUTH","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"355 PINE GROVE RD","madd2":"","madd3":"","mcity":"Sumerco","mstate":"WV","mzip":"25567","pcpfaxno":6037750247,"pcpnpi":1659415859,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3Q84QM6FX75","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R9431","S0993XA","S0990XA","S199XXA","M25551","K811","S0511XA","W010XXA","H35073","E538","K8020","G4700","F419","M25511","Z6828"],"date":["2025-03-11","2025-03-11","2025-03-11","2025-03-11","2025-03-11","2025-07-28","2025-03-11","2025-03-11","2025-01-13","2025-01-10","2025-07-15","2025-03-25","2025-03-25","2025-03-25","2025-03-25"],"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-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","","","Select","Select",""],["","","FARXIGA","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","DAPAGLIFLOZIN","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","BISOPROLOL FUMARATE","","","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":[]}},{"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":""}]}]}