{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Pamela S Burr","gend":1,"currentgend":"","add":"2 STANLEY LN","city":"Northeast Harbor","state":"ME","zip":"04662","dob":"1943-03-24","age":"","mstatus":"","insh":"10000019790","cliId":"","pno":2072763927,"cno":"","email":"","ename":"","eno":"","pphy":"WEISS, ROBERT D","ppno":2073389968,"pcpadd":"PO BOX 8,10 WAYMAN LANE","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46090008","pcpcounty":"","pcpid":"","pcpname":"COOPER GILMORE HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 91","madd2":"","madd3":"","mcity":"Northeast Harbor","mstate":"ME","mzip":"04662","pcpfaxno":2073380332,"pcpnpi":1538150503,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8DE6UM9QV58","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M810","Z0000","J189","J441","Z7689","J438","J449","J432","J440","R051","I739","I10","J439","J9611","Z23","R0902","J181","J90","J9811","Z9229","R059","Z0101","H5203","I471","Z743","A419","J984","J9691","J850","J9621","R1011","J929","R0602"],"date":["2024-08-23","2025-07-28","2023-08-02","2025-08-05","2025-04-30","2024-05-28","2025-09-05","2025-04-18","2023-09-08","2024-05-07","2024-02-05","2025-01-22","2024-05-07","2025-04-18","2024-10-03","2023-06-23","2023-06-30","2023-07-11","2023-07-11","2024-08-08","2024-05-28","2025-06-17","2025-06-17","2023-06-30","2023-06-14","2023-06-30","2023-06-30","2023-06-14","2023-06-30","2023-06-30","2025-04-18","2025-04-18","2025-04-02"],"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":[["","","SPIRONOLACTONE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","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":""}]}]}