{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Pamela C Christensen","gend":1,"currentgend":"","add":"50 FIVE CORNERS RD","city":"NEW SHARON","state":"ME","zip":"04955","dob":"1947-06-03","age":"","mstatus":"","insh":"10000018650","cliId":"","pno":2074854055,"cno":"","email":"Romeme7323@yahoo.com","ename":"","eno":"","pphy":"BOLDUC, KATELYN","ppno":2074652181,"pcpadd":"81 MEDICAL CENTER DR STE 2200,","pcpcity":"BRUNSWICK","pcpstate":"ME","pcpzip":"40112765","pcpcounty":"","pcpid":"","pcpname":"OAKLAND FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"50 FIVE CORNERS RD","madd2":"","madd3":"","mcity":"NEW SHARON","mstate":"ME","mzip":"04955","pcpfaxno":2076185670,"pcpnpi":1548647225,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4C01FP3DW96","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C20","Z510","Z08","Z1212","C787","C775","Z01818","K6389","C229","N289","R197","D6481","Z85048","Z0001","Z5111","C19","Z8542","D72819","T451X5A","Z1211","E278","Z90722","Z452","R918","R945","G629","Z79631","Z85038","C541","Z9221","R590","Z90710","K625","K624","Z923","R300","N179","E876","K6289","G620","T451X5S","D649","Z79899","K5790","D120","Z451","S30861A","K529","Z8505","Z7952","W57XXXA","K769","C189","K921","C779","N6323","N6321","Z780","Z1231","K811","N3289","R609","C55","C187","Z538","Z712","R58","R202","C801","D709","R222","K760","N281","K8689","K648","E860","R932","R188"],"date":["2025-07-03","2023-11-09","2025-08-01","2024-08-21","2025-03-20","2023-11-02","2024-11-21","2025-09-10","2024-08-19","2023-11-21","2023-12-15","2023-11-21","2025-09-10","2024-07-03","2023-08-16","2024-11-25","2025-01-30","2023-10-10","2023-11-21","2025-09-03","2025-07-03","2025-07-03","2025-09-05","2025-03-20","2023-08-02","2023-09-13","2023-08-02","2025-02-12","2025-11-10","2025-03-18","2023-05-10","2024-08-29","2023-05-24","2024-08-21","2025-03-18","2023-11-07","2023-11-07","2023-10-31","2023-10-17","2024-07-01","2024-07-01","2023-10-17","2023-10-17","2025-06-17","2023-03-28","2025-10-15","2023-07-03","2024-01-03","2025-08-01","2023-05-24","2023-07-03","2024-08-19","2024-10-25","2023-05-10","2023-05-03","2023-03-31","2023-03-31","2024-07-26","2025-07-28","2024-11-25","2024-08-30","2024-08-30","2025-11-10","2023-03-28","2025-09-03","2024-01-26","2023-07-05","2023-07-05","2025-03-20","2023-06-07","2023-03-30","2023-03-30","2023-03-30","2023-03-30","2023-03-28","2023-11-07","2024-09-05","2024-01-18"],"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",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","DIPHENOXYLATE-ATROPINE","","","Select","Select",""],["","","CAPECITABINE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","BETAMETHASONE DIPROP AUGMENTED","","","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":""}]}]}