{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sandra B Kunath","gend":1,"currentgend":"","add":"48 DUTTON HILL RD","city":"Windham","state":"ME","zip":"04062","dob":"1944-01-31","age":"","mstatus":"","insh":"00007660700","cliId":"","pno":2078997946,"cno":"","email":"sandbar44@hotmail.com","ename":"","eno":"","pphy":"WADLAND, WILLIAM R","ppno":2078282402,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2078997946,"add2":"","add3":"","madd1":"48 DUTTON HILL RD","madd2":"","madd3":"","mcity":"Windham","mstate":"ME","mzip":"04062","pcpfaxno":2078287850,"pcpnpi":1154499002,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1J97X46VP59","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R079","M79604","R072","M79661","K219","E278","L570","D492","C4442","N390","L814","L821","D1801","Z85820","T148XXA","D225","C44722","R6889","R42","S81801A","T8189XA","L03115","R3129","R5383","R0789","Z853","R4189","Z1231","Z23","J069","H524","H3540","D044","E875","R2240","C44729","H26491","D0439","M810","Z13220","Z13228","Z136","Z85828","R300","J849","I87311","M549","Z4802","K7689","D3502","M8580","J00","J0190","Z20828","L905","J984","M79605","M8589","R7989","R600","R350","I739","S81802A"],"date":["2025-08-21","2024-03-01","2024-03-01","2024-03-01","2024-06-10","2024-08-29","2023-10-04","2024-09-05","2023-11-15","2024-01-24","2025-05-06","2025-05-06","2025-05-06","2024-05-14","2025-01-21","2025-05-06","2024-11-15","2022-11-02","2024-09-09","2024-12-09","2025-01-21","2024-12-09","2024-06-26","2024-06-26","2022-11-29","2023-06-30","2024-07-09","2025-07-10","2024-10-02","2024-02-05","2023-10-02","2023-10-02","2023-11-15","2023-06-30","2023-06-30","2023-07-05","2022-10-28","2024-05-14","2025-05-08","2023-05-05","2025-05-08","2025-05-08","2022-11-02","2024-08-25","2025-08-19","2025-01-10","2024-10-19","2023-11-30","2024-07-24","2024-08-29","2024-08-20","2024-02-05","2024-02-05","2024-02-05","2024-09-05","2022-11-29","2022-11-29","2023-09-01","2024-03-01","2024-03-01","2025-08-12","2023-11-01","2024-12-09"],"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":[["","","CEPHALEXIN","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","IMIQUIMOD","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","DEXAMETHASONE","","","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":""}]}]}