{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karen H James","gend":1,"currentgend":"","add":"6 LEVI LN UNIT 104","city":"BIDDEFORD","state":"ME","zip":"04005","dob":"1951-03-12","age":"","mstatus":"","insh":"10000056333","cliId":"","pno":"2076026226","cno":"6037811062","email":"KAREN.JAMES.207@GMAIL.COM","ename":"","eno":"","pphy":"MUNROE, CHRISTINE","ppno":"2073849212","pcpadd":"GREAT WORKS FAMILY PRACTICE,57 PORTLAND ST STE 2A","pcpcity":"SOUTH BERWICK","pcpstate":"ME","pcpzip":"03908","pcpcounty":"","pcpid":"","pcpname":"GREAT WORKS FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 LEVI LN UNIT 104","madd2":"","madd3":"","mcity":"BIDDEFORD","mstate":"ME","mzip":"04005","pcpfaxno":"2073842008","pcpnpi":"1538369657","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3NN2X09CN99","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M170","Z0000","E119","E6601","U071","M109","Z0101","H16223","H524","L720","D692","Z85828","J209","M7122","M79605","M7120","Z87891","I10","Z1231"],"date":["2024-05-03","2024-04-15","2024-04-17","2024-01-30","2023-06-05","2024-03-21","2023-11-30","2023-11-30","2023-11-30","2023-11-29","2023-11-29","2023-11-29","2023-12-16","2024-01-04","2024-01-04","2024-01-11","2024-01-04","2024-04-15","2024-05-24"],"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":[["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Metformin","500 MG","","Select","Select",""],["","","Pravastatin","40 MG","","Select","Select",""],["","","Metoprolol Tart","50 MG","","Select","Select",""],["","","Amlodipine","10 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Allopurinol","100 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Tranexamic Acid","650 MG","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Ozempic","","","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":""}]}]}