{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Nancy Canino","gend":1,"currentgend":"","add":"143 ROGERS RD APT 211A","city":"KITTERY","state":"ME","zip":"03904","dob":"1954-01-13","age":"","mstatus":"","insh":"10000110069","cliId":"","pno":"6035347055","cno":"","email":"ncnino@gmail.com","ename":"","eno":"","pphy":"ABBOTT, CARA L","ppno":"6038683300","pcpadd":"Lee Family Practice,65 Calef Hwy Ste 200","pcpcity":"Lee","pcpstate":"NH","pcpzip":"03861","pcpcounty":"","pcpid":"","pcpname":"WHP LEE FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"143 ROGERS RD APT 211A","madd2":"","madd3":"","mcity":"KITTERY","mstate":"ME","mzip":"03904","pcpfaxno":"6038683303","pcpnpi":"1285132258","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2RD5XH2TH67","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M8588","E559","C50412","Z170","L309","L853","L821","D3132","E119","H2513","H52223"],"date":["2024-01-23","2024-02-05","2024-06-13","2024-06-13","2024-03-01","2024-03-01","2024-03-01","2024-05-21","2024-05-21","2024-05-21","2024-05-21"],"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":[["","","Pioglitazone","30 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Pacific","","","Select","Select",""],["","","Pantoprazole","40 MG","","Select","Select",""],["","","Metoprolol Tart","50 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Anastrozole","1 MG","","Select","Select",""],["","","Mnexspike","","","Select","Select",""],["","","Mounjaro","","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Doxepin","50 MG","","Select","Select",""],["","","Alprazolam","1 MG","","Select","Select",""],["","","Ketorolac 0.4 % Ophth Sol Pacific","","","Select","Select",""],["","","Fluzone High Dose","","","Select","Select",""],["","","Spikevax","","","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":""}]}]}