{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sandra J Sullivan","gend":1,"currentgend":"","add":"104 SUNSET DR","city":"MILLINOCKET","state":"ME","zip":"04462","dob":"1946-04-14","age":"","mstatus":"","insh":"10000012251","cliId":"","pno":2074476964,"cno":"","email":"larrynsandy1967@yahoo.com","ename":"","eno":"","pphy":"NIELSEN, LISA","ppno":2075282285,"pcpadd":"PO BOX 500,","pcpcity":"PATTEN","pcpstate":"ME","pcpzip":"47650500","pcpcounty":"","pcpid":"","pcpname":"KATAHDIN VALLEY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2072995252,"add2":"","add3":"","madd1":"104 SUNSET DR","madd2":"","madd3":"","mcity":"MILLINOCKET","mstate":"ME","mzip":"04462","pcpfaxno":2075282880,"pcpnpi":1598706970,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3EV8XC7PT49","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z45018","E119","D649","D509","L98491","I161","D485","K7460","I2510","C44519","L821","I10","J189","R0902","H401133","H43813","Z8619","I110","H35371","R0602","Z743","D225","L814","E1165","H401132","Z0000","R300","Z0101","D61818","E782","E785","C220","Z130","N184","E1122","Z08","Z85828","M7918","R197","K7469","I2720","Z87891","I517","Z8679","I080","Z950","I350","I771","R6889","I129","K760","J90","R000","K769","H43393","Z23","R0600","Z955","Z09","I509","Z1289","B999","E118","E039","K7400"],"date":["2025-08-03","2025-03-26","2025-06-13","2025-07-22","2025-03-06","2024-09-05","2025-03-06","2025-07-24","2025-02-03","2024-03-01","2024-09-03","2025-03-13","2024-09-05","2024-09-05","2024-10-01","2023-09-13","2023-12-05","2024-09-04","2025-05-06","2024-09-04","2024-09-04","2024-09-03","2024-09-03","2023-09-28","2025-04-01","2024-12-12","2024-09-10","2024-10-09","2022-11-01","2024-12-06","2023-11-28","2025-01-23","2023-06-22","2025-01-13","2025-08-25","2025-03-06","2025-03-06","2025-07-10","2024-09-11","2024-07-18","2025-02-21","2025-02-21","2025-02-21","2025-02-21","2023-05-19","2024-02-15","2025-01-17","2023-01-25","2023-08-16","2025-01-30","2023-01-25","2024-09-04","2024-09-04","2025-01-23","2024-03-20","2023-11-16","2024-09-04","2022-11-17","2024-09-17","2024-09-18","2023-12-28","2024-04-02","2022-09-06","2022-09-06","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":[["","","METFORMIN HCL ER","","","Select","Select",""],["","","ISOSORBIDE DINITRATE","","","Select","Select",""],["","","DORZOLAMIDE-TIMOLOL","","","Select","Select",""],["","","TRUE METRIX GLUCOSE TEST STRIP","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","BETAMETHASONE DIPROP AUGMENTED","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TRUE METRIX BLOOD GLUCOSE MTR","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ULTRA-FINE SHORT PEN NEEDLE","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","CAREONE","","","Select","Select",""],["","","QUINAPRIL HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","GLIPIZIDE","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","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":{"indx":[],"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":""}]}]}