{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carolyn B Thomas","gend":1,"currentgend":"","add":"4 BEECH HILL RD","city":"Mount Desert","state":"ME","zip":"04660","dob":"1945-07-06","age":"","mstatus":"","insh":"00008563900","cliId":"","pno":2072447372,"cno":"","email":"brownbunny4560@gmail.com","ename":"","eno":"","pphy":"LAWSON, KATHERINE L","ppno":2072885024,"pcpadd":"10 WAYMAN LN,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46091625","pcpcounty":"","pcpid":"","pcpname":"COOPER GILMORE HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2072447372,"add2":"","add3":"","madd1":"4 BEECH HILL RD","madd2":"","madd3":"","mcity":"Mount Desert","mstate":"ME","mzip":"04660","pcpfaxno":"","pcpnpi":1700018645,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9FQ6W38JH67","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K5733","M1711","F411","N898","Z0000","M25561","Z1231","Z23","K589","M2041","K8020","K5730","N281","R21","F349","Z0100","H401231","H04123","J40","E782","E0789","Z780","L259","M7061","R109","S83241D","B353","R1031","K5900","K5732","H43813","F4312","N390","K654","K760","R1013","R531","R7401","W57XXXA","A7749","R55","E785","R29818","R059","R509","R9082","R112","N179","Z09"],"date":["2025-06-27","2024-09-12","2025-08-22","2025-07-25","2025-07-15","2024-09-04","2024-12-05","2024-10-16","2023-02-21","2023-06-29","2025-06-29","2025-06-29","2025-06-29","2023-11-14","2024-08-24","2023-01-04","2024-06-11","2023-12-22","2023-11-06","2025-05-06","2025-05-06","2024-12-05","2023-08-08","2023-11-29","2025-08-20","2024-04-24","2022-12-20","2025-08-20","2025-08-20","2025-06-25","2022-10-25","2025-01-14","2022-08-22","2022-08-19","2022-08-22","2022-08-22","2022-08-19","2022-08-21","2022-08-22","2022-08-22","2022-08-22","2022-08-17","2022-08-19","2022-08-19","2022-08-18","2022-08-19","2022-08-18","2022-08-19","2022-08-30"],"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":[["","","LATANOPROST","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","CICLOPIROX","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","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":""}]}]}