{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Warren H Clement","gend":0,"currentgend":"","add":"138 CRANBERRY MEADOW RD","city":"BERWICK","state":"ME","zip":"03901","dob":"1942-11-21","age":"","mstatus":"","insh":"10000014175","cliId":"","pno":"2076981505","cno":"","email":"CLFARM138@gmail.com","ename":"","eno":"","pphy":"ROSIC, GREGORY G","ppno":"","pcpadd":"PO BOX 412503,","pcpcity":"BOSTON","pcpstate":"MA","pcpzip":"22412503","pcpcounty":"","pcpid":"","pcpname":"WHP INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"6038172165","add2":"","add3":"","madd1":"138 CRANBERRY MEADOW RD","madd2":"","madd3":"","mcity":"BERWICK","mstate":"ME","mzip":"03901","pcpfaxno":"","pcpnpi":"1699161018","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1M75RG4NN56","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M458","N3941","N401","R339","N138","R159","J449","M5450","Z85038","F419","M533","E782","I10","M5416","R531","M7918","I351","I7121","I951","Z1211","K5752","K56609","K5730","B351","Z79899","M1280","M47817","G609","R413","I352","L570","L821","D229","L814","L578","N3946","D539","Z9079","D509","Z961","H04123","M542","M25519","H26492","R42","R0602","R55","S0990XA","I493","I499","R29818","M459","R2681","R0609","M4726","R739","Z09","M25552","Z1589","G5703","Z96642","Z791"],"date":["2024-06-20","2024-04-05","2024-03-05","2024-03-08","2024-03-05","2023-07-27","2025-03-05","2024-06-07","2023-07-27","2023-05-19","2023-05-23","2023-05-23","2025-09-05","2025-09-22","2025-01-06","2026-01-29","2023-06-30","2025-07-03","2024-06-23","2023-07-10","2023-07-10","2023-07-10","2023-07-27","2026-02-19","2024-07-18","2024-02-05","2025-09-22","2023-09-20","2023-09-20","2025-07-03","2025-06-18","2025-06-18","2025-06-18","2025-06-18","2025-06-18","2023-11-29","2024-02-01","2024-03-07","2024-03-07","2025-04-28","2025-04-28","2024-06-07","2024-06-07","2024-04-25","2024-06-25","2024-06-23","2024-08-02","2024-06-23","2024-06-23","2024-07-03","2025-03-05","2024-08-02","2024-08-02","2024-08-21","2025-01-11","2026-01-06","2025-07-03","2024-11-18","2025-09-05","2026-01-02","2024-11-18","2025-02-05"],"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":[["","","DULOXETINE","30 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","ATORVASTATIN","10 MG","","Select","Select",""],["","","CARBIDOPA\/LEVODOPA","25\/100 MG","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","Clotrim\/Betameth Diprop 1\/0.05 % Cream Fou","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","RIVASTIGMINE","4.6 MG\/24","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","DIAZEPAM","5 MG","","Select","Select",""],["","","DONEPEZIL","10 MG","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","MEMANTINE","10 MG","","Select","Select",""],["","","Fluad Quad 2023-2024","","","Select","Select",""],["","","FLUTICASONE PROP\/SALMETEROL","250\/50 MCG","","Select","Select",""],["","","FINASTERIDE","5 MG","","Select","Select",""],["","","Amlodipine","2.5 MG","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","METHYLPREDNISOLONE","4 MG","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","CLOTRIM\/BETAMETH DIPROP","1\/0.05 %","","Select","Select",""],["","","FLUAD QUAD","","","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":""}]}]}