{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joyce E Cirone","gend":1,"currentgend":"","add":"379 FRONT RIDGE","city":"Orland","state":"ME","zip":"04472","dob":"1936-10-30","age":"","mstatus":"","insh":"10000014478","cliId":"","pno":2075980858,"cno":"","email":"CHASMORRISON@ATT.NET","ename":"","eno":"","pphy":"WILLEY, SARA","ppno":2074697371,"pcpadd":"Bucksport Regional Health Center,110 Broadway","pcpcity":"Bucksport","pcpstate":"ME","pcpzip":"04416","pcpcounty":"","pcpid":"","pcpname":"BUCKSPORT REGIONAL HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"379 FRONT RIDGE","madd2":"","madd3":"","mcity":"Orland","mstate":"ME","mzip":"04472","pcpfaxno":2074697306,"pcpnpi":1295101129,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2PH3G48UA75","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I2510","I083","I130","I5032","I350","D500","I080","N1830","I4821","I10","N184","Z1231","Z79899","R300","C50919","J432","D509","I5020","N189","D649","M10472","C50912","Z170","Z79811","M85859","Z923","C773","M79671","R0602","I480","R0600","I4891","I7389","M79662","M79661","Z7901","C50112","I493","C3490","G43709","Z08","E785","E039","Z0000","I499","I501","I5A","G4762","I340","R69","Q2112","Z955","Z853","C50812","M8589","F5101","H04123","H43813","G4700"],"date":["2024-11-26","2023-06-06","2024-12-02","2023-08-28","2025-07-21","2023-08-11","2025-07-02","2023-09-20","2024-11-27","2025-07-21","2025-08-20","2023-04-06","2023-11-08","2024-07-25","2023-05-22","2023-05-22","2023-02-09","2024-11-26","2024-11-26","2023-05-18","2024-02-22","2023-06-23","2023-06-23","2023-03-16","2023-06-23","2023-06-23","2023-03-16","2025-08-20","2024-05-15","2023-09-08","2023-08-22","2024-08-02","2022-10-20","2022-10-20","2022-10-20","2022-10-20","2023-05-26","2024-08-02","2024-12-02","2024-12-02","2023-05-26","2023-08-11","2023-09-08","2023-02-14","2023-08-22","2023-08-30","2023-08-24","2023-06-09","2023-05-01","2023-09-08","2023-08-04","2023-08-04","2023-05-18","2023-05-22","2022-10-04","2023-10-25","2022-09-29","2022-09-29","2022-09-01"],"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":[["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","DIGOXIN","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","DOXEPIN HCL","","","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":""}]}]}