{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara S Johnson","gend":1,"currentgend":"","add":"104 BERWICK RD","city":"South Berwick","state":"ME","zip":"03908","dob":"1947-12-26","age":"","mstatus":"","insh":"10000021240","cliId":"","pno":"6038666285","cno":"","email":"blynnj@protonmail.com","ename":"","eno":"","pphy":"DION, SARA M","ppno":"2073489212","pcpadd":"21 CLARK WAY,","pcpcity":"SOMERSWORTH","pcpstate":"NH","pcpzip":"38784401","pcpcounty":"","pcpid":"","pcpname":"GREAT WORKS FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"104 BERWICK RD","madd2":"","madd3":"","mcity":"South Berwick","mstate":"ME","mzip":"03908","pcpfaxno":"2073842008","pcpnpi":"1154970093","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3WD2JV7GE04","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H353211","H353122","R197","E559","J45909","R1084","A0472","Z86010","E1140","R6889","E1165","H04123","H0288A","H0288B","H16232","L309","L218","L298","H353231","Z961","L239","L649","R21","Z1231","Z0000","M3313","M3390","E785","R918","I517","M3300","M3312","I441","R1013","R945","R933","E1141","Z431","R6330","I491","R0782","R531","R1314","R7401","R1312","E6601","R5383","Z7409","R489","R1310","R296","I700","R058","T17320A","K8020","R7989","E119","H353221","I890","S20321A","R262","Z736","E118","M3212","I10","I4891","I459","J690","Z79899","S30821D","S20121A","K2289","H524","H353230","J45901","J189","M3310","Z7401","D23112","H02881","H02884","H1789"],"date":["2024-03-11","2024-03-11","2024-08-16","2023-04-17","2025-12-15","2023-06-16","2023-06-16","2023-06-16","2026-02-20","2023-08-08","2024-06-20","2024-05-14","2023-09-21","2023-09-21","2024-05-14","2024-04-16","2024-03-19","2024-04-16","2025-12-23","2026-02-12","2024-04-16","2024-04-16","2024-02-28","2024-05-10","2025-06-24","2024-07-29","2024-10-23","2024-06-18","2024-08-16","2024-06-18","2024-06-27","2026-01-15","2025-03-26","2024-08-24","2024-08-24","2024-08-24","2026-01-14","2025-05-06","2025-05-06","2024-12-20","2024-08-16","2024-10-03","2024-08-23","2025-01-28","2024-08-22","2026-01-14","2025-05-05","2024-10-23","2024-10-23","2024-10-23","2024-08-16","2024-08-16","2024-08-16","2024-08-16","2024-08-16","2024-08-16","2025-06-24","2026-02-12","2025-03-12","2024-10-29","2024-10-31","2024-10-31","2024-10-28","2025-03-13","2024-10-19","2024-10-19","2026-01-28","2024-09-23","2024-06-27","2024-11-05","2024-11-05","2024-10-02","2025-04-18","2025-04-18","2024-11-05","2024-10-03","2024-10-03","2024-10-03","2023-03-16","2023-03-16","2023-03-16","2023-03-16"],"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":[["","","METHOTREXATE","25 MG\/ML","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","OLMESARTAN","20 MG","","Select","Select",""],["","","Tacrolimus 0.03 % Ointment Accord","","","Select","Select",""],["","","POTASSIUM CL","20 MEQ","","Select","Select",""],["","","HYDROXYCHLOROQUINE","200 MG","","Select","Select",""],["","","MIEBO","","","Select","Select",""],["","","Tacrolimus 0.03 % Ointment Glenmark","","","Select","Select",""],["","","FLOVENT HFA","","","Select","Select",""],["","","ZOLPIDEM","5 MG","","Select","Select",""],["","","ONETOUCH ULTRA","","","Select","Select",""],["","","CYCLOBENZAPRINE","5 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","FASENRA PEN","","","Select","Select",""],["","","LANCETS","30G LANCET","","Select","Select",""],["","","SERTRALINE","100 MG","","Select","Select",""],["","","ARNUITY ELLIPTA","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","INSULIN GLARGINE-YFGN","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","METOPROLOL SUCC","50 MG","","Select","Select",""],["","","Bd Ultra-Fine Mini (Ref 320119)","","","Select","Select",""],["","","VANCOMYCIN","125 MG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","LEUCOVORIN","10 MG","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","ROSUVASTATIN","20 MG","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","Clobetasol 0.05 % Ointment Encube","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","CELECOXIB","100 MG","","Select","Select",""],["","","FLUTICASONE PROP HFA","110 MCG","","Select","Select",""],["","","DIFICID","","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","TRESIBA FLEXTOUCH","","","Select","Select",""],["","","MONTELUKAST","10 MG","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","BD ULTRA-FINE MINI (REF","","","Select","Select",""],["","","CLOBETASOL","0.0005","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","TACROLIMUS","0.0003","","Select","Select",""],["","","FLUZONE HIGH-DOSE 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":""}]}]}