{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Patricia J Pineo","gend":1,"currentgend":"","add":"3 LONG SWAMP RD","city":"Berwick","state":"ME","zip":"03901","dob":"1951-03-27","age":"","mstatus":"","insh":"10000093453","cliId":"","pno":"6035343310","cno":"","email":"trishjoi.pp@gmail.com","ename":"","eno":"","pphy":"BOONE, EMILY ANNE B","ppno":"","pcpadd":"\tMartins Point Health Care,\t161 Corporate Dr","pcpcity":"Portsmouth","pcpstate":"NH","pcpzip":"03801","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3 LONG SWAMP RD","madd2":"","madd3":"","mcity":"BERWICK","mstate":"ME","mzip":"03901","pcpfaxno":"6039454339","pcpnpi":"1952962623","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5GY5GT3PT82","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G894","S3282XA","G5681","M461","Z79891","E611","M25551","S32591D","S3282XD","M7071","M25511","M85852","Z1231","M7918","I10","E782","E039","R42","M8589","M810","Z79899","R350","R3915","R300","R9431","R0609","I208","R928","M170","M47816","M479","M47817","M1712","M1711","G43909","M47819","H25812","H25813","H25811","N390","H2511","H2512","N952","R339","S3722XD","I480"],"date":["2024-03-01","2023-07-20","2023-04-03","2024-03-01","2024-04-10","2024-06-10","2024-03-21","2023-05-01","2023-08-17","2023-08-16","2023-07-20","2023-05-22","2023-05-22","2023-05-30","2024-04-24","2023-05-26","2024-01-23","2023-05-22","2023-05-26","2023-05-26","2023-10-12","2023-12-09","2023-12-09","2023-12-09","2023-10-13","2023-10-13","2023-07-20","2023-07-24","2023-11-08","2023-08-23","2023-08-17","2023-08-23","2023-09-14","2023-09-14","2024-03-21","2023-10-12","2024-01-23","2023-12-11","2024-01-16","2024-06-14","2024-01-16","2024-01-23","2024-06-14","2024-06-14","2024-06-14","2024-06-21"],"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":[["","","Amoxicillin","500 MG","","Select","Select",""],["","","Tramadol","50 MG","","Select","Select",""],["","","Metoprolol Tart","100 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Levothyroxine","125 MCG","","Select","Select",""],["","","Topiramate","25 MG","","Select","Select",""],["","","Meclizine","25 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Alendronate","70 MG","","Select","Select",""],["","","Buprenorphine","5 MCG","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Atorvastatin","80 MG","","Select","Select",""],["","","Fluzone High Dose","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Butal\/Acetaminophen\/Caffeine (Exempt) 50\/3","","","Select","Select",""],["","","Isosorbide Mononitrate","60 MG","","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":""}]}]}