{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara Walker","gend":1,"currentgend":"","add":"10 NEWTON RD","city":"Bath","state":"ME","zip":"04530","dob":"1947-01-07","age":"","mstatus":"","insh":"10000016764","cliId":"","pno":2075044416,"cno":"","email":"","ename":"","eno":"","pphy":"TRAPP, KATHLEEN R","ppno":2077984400,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"10 NEWTON RD","madd2":"","madd3":"","mcity":"Bath","mstate":"ME","mzip":"04530","pcpfaxno":2078287850,"pcpnpi":1386603397,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7UE4JF2XE84","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E0520","R1011","R1033","M5450","R300","K219","F03918","N390","R451","F0390","I10","R1013","R110","E041","N3289","R5383","R413","R4182","R262","G319","E042","R1010","N1830","I129","E049","R221","K5900","K5730","K429","R0600","Z0189","E0590","M810","R627","R42","B351","M79675","M79674","L602","M2011","Z0000","M8580","R410","Z9009","R1084","R079","R55"],"date":["2023-06-19","2025-02-02","2025-02-02","2025-02-02","2024-07-05","2024-12-11","2024-12-11","2024-07-10","2024-07-10","2024-07-10","2025-08-13","2024-02-08","2024-02-08","2022-11-01","2025-02-02","2023-09-22","2024-06-02","2024-06-02","2024-06-02","2024-06-02","2022-11-01","2024-02-08","2023-12-02","2023-09-22","2023-06-19","2024-12-06","2024-02-08","2024-02-08","2024-02-08","2024-02-08","2024-02-08","2023-10-05","2023-03-06","2024-06-02","2024-06-02","2025-04-25","2025-04-25","2025-04-25","2025-04-25","2025-04-25","2023-06-05","2023-06-05","2024-06-02","2022-10-11","2025-02-02","2025-02-02","2022-08-30"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","RIVASTIGMINE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","METHIMAZOLE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","CEFUROXIME","","","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":""}]}]}