{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Nanci J Lord","gend":1,"currentgend":"","add":"11 BIRCHWOOD DR","city":"Limington","state":"ME","zip":"04049","dob":"1946-10-11","age":"","mstatus":"","insh":"10000019168","cliId":"","pno":2072985251,"cno":"","email":"DECLINED@04152025.COM","ename":"","eno":"","pphy":"FOX, MAURA","ppno":2077745816,"pcpadd":"InterMed,100 Foden Rd Ste 203","pcpcity":"South Portland","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"11 BIRCHWOOD DR","madd2":"","madd3":"","mcity":"Limington","mstate":"ME","mzip":"04049","pcpfaxno":2078741483,"pcpnpi":1184201188,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9KP5FX9CJ57","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R8281","N393","Z1231","R1030","R002","N3946","N3642","I10","E785","Z0001","M25551","J984","L900","Z23","H353121","R0602","E559","Z0000","K219","Z1211","K635","Z860101","K648","M810","H00021","H25813","R197","Z87891","N3281","N281","N3289","Z96642","Z96641","Z471","M419","R059","Z1239","E781","R3129"],"date":["2023-02-22","2023-03-02","2024-10-02","2023-03-24","2024-04-25","2023-05-30","2023-03-02","2024-03-01","2024-03-01","2024-02-29","2025-06-12","2024-03-01","2023-02-22","2025-03-04","2025-11-04","2024-04-09","2024-03-01","2025-03-04","2023-03-02","2024-11-20","2024-11-20","2024-11-20","2024-11-20","2024-10-17","2024-09-04","2025-11-04","2023-03-24","2023-03-24","2024-06-27","2023-03-24","2023-03-24","2022-07-20","2022-07-20","2022-07-20","2022-07-20","2022-01-03","2022-01-03","2022-01-03","2022-01-03"],"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":[["","","OXYBUTYNIN CHLORIDE ER","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CELECOXIB","","","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":[]}},{"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":""}]}]}