{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Georgie A Woodford","gend":1,"currentgend":"","add":"719 SALEM RD","city":"Kingfield","state":"ME","zip":"04947","dob":"1944-07-21","age":"","mstatus":"","insh":"10000008893","cliId":"","pno":2072654971,"cno":"","email":"GGWOODFORD@YAHOO.COM","ename":"","eno":"","pphy":"ZAVOTSKY, DIANE","ppno":2076724187,"pcpadd":"Bingham Area Health Center,237 Main St","pcpcity":"Bingham","pcpstate":"ME","pcpzip":"00000","pcpcounty":"","pcpid":"","pcpname":"MOUNT ABRAM REGIONAL HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2072654971,"add2":"","add3":"","madd1":"719 SALEM RD","madd2":"","madd3":"","mcity":"Kingfield","mstate":"ME","mzip":"04947","pcpfaxno":2076723641,"pcpnpi":1023128261,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8C57D90MN44","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I495","C44319","Z1231","R0789","Z950","I10","I491","M7910","I480","I25119","Z7901","R29898","S20212A","I441","I4891","R9431","I517","H40023","L989","H524","M79672","M19072","M2042","Z45018","M7751","I499","R0989","I493","M79605","I459","Z0000","M5450","I360","R600","D492","R079","R531","I700","B372","K7689","Z23","M47816","M48061","R5383","Z9049","K828","I455"],"date":["2023-03-07","2023-08-31","2025-08-26","2024-08-14","2025-10-30","2025-07-15","2024-08-14","2025-04-29","2024-08-29","2025-07-11","2024-04-22","2024-04-22","2023-01-12","2025-05-14","2023-07-02","2022-12-20","2022-12-20","2025-06-24","2023-07-02","2025-06-24","2024-10-15","2024-10-15","2024-10-15","2024-01-19","2024-11-26","2022-12-19","2023-03-07","2024-08-14","2025-06-25","2023-02-07","2025-10-31","2025-09-02","2025-07-11","2025-07-11","2023-04-18","2022-12-19","2022-12-19","2022-12-19","2024-03-25","2023-02-16","2023-10-17","2025-09-02","2025-09-02","2022-12-19","2023-02-16","2023-02-16","2023-03-07"],"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":[["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","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":""}]}]}