{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Melanie S Jackson","gend":1,"currentgend":"","add":"5 ALL SEASONS WAY APT B","city":"TRENTON","state":"ME","zip":"04605","dob":"1958-03-14","age":"","mstatus":"","insh":"10000009975","cliId":"","pno":2078019508,"cno":"","email":"msuec2003@yahoo.com","ename":"","eno":"","pphy":"HANSON, CASEY S","ppno":2076675899,"pcpadd":"PO BOX 8,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46090008","pcpcounty":"","pcpid":"","pcpname":"TRENTON HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"5 ALL SEASONS WAY APT B","madd2":"","madd3":"","mcity":"TRENTON","mstate":"ME","mzip":"04605","pcpfaxno":2078015123,"pcpnpi":1164536397,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3NE0Q43YU27","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J431","R079","I10","R091","R0789","R509","S62636A","X58XXXA","J439","M549","R0781","S60946","M7989","Z0000","D72829","R071","Z23","Z4889","Z4800","S81802A","L03116","L723","R194","L989"],"date":["2024-12-03","2023-05-31","2023-09-18","2023-03-22","2023-09-25","2022-11-02","2023-06-19","2023-06-19","2023-03-21","2022-11-16","2025-03-18","2023-05-01","2023-05-01","2023-05-01","2023-09-20","2023-03-16","2022-11-17","2022-09-16","2022-09-23","2022-09-26","2022-08-22","2022-09-09","2022-08-31","2022-09-06"],"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":[["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","VARENICLINE TARTRATE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}