{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara Garrey","gend":1,"currentgend":"","add":"119 CAT MOUSAM RD UNIT 21","city":"Kennebunk","state":"ME","zip":"04043","dob":"1947-02-01","age":"","mstatus":"","insh":"10000016037","cliId":"","pno":3035895256,"cno":"","email":"bgarrey1@gmail.com","ename":"","eno":"","pphy":"ADAMS, TODD","ppno":2076468386,"pcpadd":"York Hospital Internal Medicine of York,277 Post Rd","pcpcity":"Moody","pcpstate":"ME","pcpzip":"04054","pcpcounty":"","pcpid":"","pcpname":"WEBHANNET INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"119 CAT MOUSAM RD UNIT 21","madd2":"","madd3":"","mcity":"Kennebunk","mstate":"ME","mzip":"04043","pcpfaxno":2076412855,"pcpnpi":1427165778,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6Y36FK6DR84","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E876","I4819","H532","Z0101","J050","Z7901","E1142","K219","G4733","H6123","Z0000","R270","Z713","Z9884","L570","D225","L814","L821","L853","H35363","R0602","J441","M4802","L989","R269","J301","J381","R9082","G319","C641","Z1231","Z86010","D123","K621","K317","M1A9XX0","Z1211","E611","E039","Z7189","H43812","M85852","M85832","G629","R110","Z85528","I679","H35372","E6601","Z6841","E119","R4182","N182","E213","R140","E7800","E079","H26493","A419","M109","M8589","R29898","I10","I4891","K5909","I5089","R1084","N6313","R1013","Z48815","D485","D2339","R0789","R531","K2289","R1110","Z6842","K449","Z09","K2940","K31A19","D171","Z01818","Z20822","C649"],"date":["2024-04-29","2024-12-31","2024-12-04","2024-01-09","2023-12-01","2025-05-28","2024-11-13","2023-05-08","2023-08-01","2023-05-08","2024-05-28","2024-05-07","2023-05-15","2025-07-01","2024-03-22","2025-01-15","2025-01-15","2025-01-15","2023-10-26","2025-06-06","2024-07-27","2023-12-01","2024-02-25","2024-03-08","2023-06-07","2024-11-29","2024-11-29","2024-02-25","2024-02-25","2024-09-26","2025-09-10","2023-11-07","2023-11-07","2023-11-07","2023-11-07","2023-05-09","2023-11-07","2024-01-22","2025-11-12","2025-01-15","2023-11-09","2024-05-23","2024-05-23","2023-06-20","2024-07-27","2024-08-15","2025-05-06","2024-05-24","2023-07-12","2023-01-03","2023-01-03","2024-07-29","2024-07-30","2025-11-12","2022-11-30","2025-11-12","2022-11-30","2025-06-06","2024-07-27","2022-12-26","2024-05-23","2022-11-02","2025-04-30","2025-11-12","2023-07-28","2023-07-28","2023-07-28","2023-02-02","2023-07-12","2023-07-12","2022-10-20","2022-10-20","2022-09-27","2022-08-24","2022-09-06","2022-09-06","2022-06-29","2022-06-29","2022-07-07","2022-06-29","2022-06-29","2022-06-29","2022-06-23","2022-06-16","2022-06-15"],"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":[["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","PLENVU","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","CINACALCET HCL","","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","HYOSCYAMINE SULFATE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}