{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Helen Andronaco","gend":1,"currentgend":"","add":"22 DAVIS RD","city":"WEST Buxton","state":"ME","zip":"04093","dob":"1944-04-11","age":"","mstatus":"","insh":"10000020770","cliId":"","pno":2076426521,"cno":"","email":"","ename":"","eno":"","pphy":"WATTS, JENNIFER L","ppno":2078392559,"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":"22 DAVIS RD","madd2":"","madd3":"","mcity":"Buxton","mstate":"ME","mzip":"04093","pcpfaxno":2075231135,"pcpnpi":1679926828,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7UT9AG9MC44","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1831","R600","E876","N1830","Z1231","I700","E119","G4733","Z23","Z713","N3941","N3281","R301","M109","N179","E8352","E873","I10","I083","E785","M67442","M19042","M720","I350","I5031","I422","H16223","R350","R0683","H35372","R3129","R058","R0902","Z0101","I080"],"date":["2023-04-11","2024-05-10","2023-10-13","2025-03-27","2024-05-14","2024-05-02","2025-05-19","2025-11-17","2024-09-13","2023-03-10","2025-06-11","2025-06-11","2025-06-11","2023-03-06","2023-03-01","2023-03-01","2023-03-01","2025-01-09","2024-09-23","2025-05-19","2024-10-23","2024-10-23","2024-10-23","2023-09-25","2024-09-23","2024-09-23","2025-10-06","2023-01-13","2025-06-03","2025-06-12","2023-01-20","2025-04-28","2025-06-03","2022-10-14","2022-10-13"],"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":[["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIP","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","XDEMVY","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","ONETOUCH VERIO REFLECT METER","","","Select","Select",""],["","","ACCU-CHEK GUIDE TEST STRIP","","","Select","Select",""],["","","ONETOUCH VERIO METER","","","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":""}]}]}