{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James Smith","gend":0,"currentgend":"","add":"81 TINA LN","city":"Parsonsfield","state":"ME","zip":"04047","dob":"1946-10-29","age":"","mstatus":"","insh":"10000017392","cliId":"","pno":"2076152456","cno":"","email":"inn2itive@hotmail.com","ename":"","eno":"","pphy":"GALBRAITH, KATHRYN L","ppno":"","pcpadd":"44 ELM ST,","pcpcity":"LIMERICK","pcpstate":"ME","pcpzip":"40483924","pcpcounty":"","pcpid":"","pcpname":"GALBRAITH FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2076251308","add2":"","add3":"","madd1":"81 TINA LN","madd2":"","madd3":"","mcity":"Parsonsfield","mstate":"ME","mzip":"04047","pcpfaxno":"2077939587","pcpnpi":"1740240290","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7HH3Y29GQ17","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z950","Z45018","E785","E1121","I10","E1165","I2510","N1832","Z0101","C4442","L821","D1801","L814","Z85828","D492","L570","I255","R6889","E875","N1831","I083","I5020","I4821","I442","I872","E119","I890","L97921","M25562","E1159","I739","B351","L851","N1830","M25462","E1122","D044","N189","Z0100","L739","C44222","N182"],"date":["2026-01-07","2023-07-14","2025-10-03","2023-06-15","2025-12-01","2025-10-03","2026-01-27","2023-09-21","2026-01-20","2026-01-21","2025-01-22","2024-01-24","2024-01-24","2024-01-24","2026-01-21","2025-01-22","2026-01-27","2023-12-30","2024-05-30","2025-12-01","2024-06-28","2024-06-28","2025-10-03","2025-07-03","2025-12-03","2024-12-02","2025-11-13","2025-11-06","2025-10-10","2025-10-23","2025-10-23","2025-10-23","2025-10-23","2025-10-01","2025-10-10","2025-12-01","2026-01-21","2024-11-19","2025-01-14","2025-01-22","2025-01-22","2023-02-16"],"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":[["","","ENTRESTO","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","SACUBITRIL\/VALSARTAN","49\/51 MG","","Select","Select",""],["","","LIRAGLUTIDE","6 MG\/ML","","Select","Select",""],["","","ROSUVASTATIN","20 MG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","METOPROLOL SUCC","100 MG","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","Fluorouracil 5 % Cream Taro","","","Select","Select",""],["","","FLUOROURACIL","0.05","","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":""}]}]}