{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda J Macphee","gend":1,"currentgend":"","add":"11 HAGAR ST","city":"Richmond","state":"ME","zip":"04357","dob":"1947-05-11","age":"","mstatus":"","insh":"10000020045","cliId":"","pno":2077374768,"cno":2075303286,"email":"benandcolby511@gmail.com","ename":"","eno":"","pphy":"CHELEUITTE, RAMON E","ppno":"","pcpadd":"12 Spruce St Ste 7,","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"11 HAGAR ST","madd2":"","madd3":"","mcity":"Richmond","mstate":"ME","mzip":"04357","pcpfaxno":2076219766,"pcpnpi":1114059672,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1TG9HH7ER27","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J449","E119","I2510","F419","N898","M25551","R262","M549","R8290","K5900","R0989","M48061","M47816","G8929","M25461","M25561","I10","E782","I25118","M5450","M160","M5134","M47814","M4185","M546","D320","K5909","M4714","R260","R21","R270","D329","Z23","M25552","B3731","N9089","L578","L814","Z808","L821","Z01818","M48062","R600","M2041","M2042","G629","M4856XA","M4725","M4726","M4186","M4716","M4804","D1809","M419","Z4789","N760","R300","G4700","L259"],"date":["2025-03-06","2025-09-09","2025-05-27","2025-03-06","2025-04-15","2024-04-09","2024-04-09","2023-09-20","2025-04-17","2025-04-15","2023-09-20","2024-08-09","2023-10-03","2023-10-03","2023-10-03","2023-10-03","2025-05-27","2025-05-28","2024-06-26","2023-11-03","2023-10-03","2024-03-25","2024-05-08","2023-10-03","2023-10-03","2025-01-25","2025-03-27","2025-01-09","2025-01-09","2025-05-27","2024-10-16","2024-10-16","2023-11-03","2023-11-03","2025-05-01","2025-08-07","2023-06-29","2023-06-29","2023-06-29","2023-06-29","2024-06-24","2024-08-01","2024-08-09","2024-05-30","2024-05-30","2024-05-30","2024-08-01","2024-06-24","2024-06-24","2024-06-24","2024-06-24","2024-05-08","2024-05-08","2024-05-08","2024-09-03","2024-09-11","2025-05-14","2022-08-12","2022-08-12"],"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":[["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","LINZESS","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PREDNISONE","","","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":""}]}]}