{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Roberta J Bowden","gend":1,"currentgend":"","add":"300 OLD COUNTY RD","city":"ETNA","state":"ME","zip":"04434","dob":"1959-12-08","age":"","mstatus":"","insh":"10000015480","cliId":"","pno":2073561796,"cno":"","email":"bobbiejorb@gmail.com","ename":"","eno":"","pphy":"ROXAS, RODRIGO C","ppno":2079073777,"pcpadd":"EMMC Family Medicine of Brewer,234 State St","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"300 OLD COUNTY RD","madd2":"","madd3":"","mcity":"ETNA","mstate":"ME","mzip":"04434","pcpfaxno":2077778800,"pcpnpi":1023204641,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3RV4U98RP66","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z780","M8589","Z1231","I739","G43709","F410","F411","Z720","Z79899","Z87891","K219","R42","J449","J4531","F17210","N3001","N958","R079","R1030","K5190","M5431","M8580","R0789","M25551","M7061","N3000","Z23","N390","J441","Z122","I4519","R9431","Z5321","R058","R300","M160","J4521","Z0101","Z0000","E785","F17200","R1310","J069","Z8719","Z01818","J101","Z5181","K2289","J45901","R1013","M5441","R051","G8929","K279","R350","H5310","D120","D122","K635","Z86010","Z1211","K5730","F349","R309"],"date":["2025-07-28","2025-07-28","2025-07-28","2024-07-08","2024-07-08","2025-09-23","2025-09-23","2025-09-23","2025-09-23","2024-09-25","2024-12-04","2025-11-07","2025-11-07","2025-11-07","2025-03-14","2023-09-12","2023-09-12","2025-06-27","2024-01-04","2024-01-04","2024-07-02","2025-08-07","2025-06-27","2024-08-21","2024-08-21","2025-08-11","2024-10-05","2025-08-11","2025-08-21","2024-09-21","2023-05-16","2023-05-16","2024-01-13","2023-10-02","2023-05-09","2024-07-02","2025-08-21","2025-10-21","2025-06-24","2023-07-18","2024-09-21","2024-12-04","2025-01-29","2024-12-04","2024-02-14","2025-02-07","2023-03-21","2023-05-12","2024-12-31","2023-07-07","2025-05-12","2025-08-21","2025-05-12","2023-07-07","2024-12-06","2023-07-11","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-10-28","2022-10-21"],"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":[["","","NITROGLYCERIN","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","CLONAZEPAM","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","FAMOTIDINE","","","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":""}]}]}