{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ruth L Robinson","gend":1,"currentgend":"","add":"194 CASCO RD","city":"Naples","state":"ME","zip":"04055","dob":"1932-05-18","age":"","mstatus":"","insh":"10000022251","cliId":"","pno":2076936539,"cno":"","email":"declined@09012023.com","ename":"","eno":"","pphy":"RIVARD, GARY S","ppno":2075243501,"pcpadd":"180 CHURCH HILL RD,STE 1","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"194 CASCO RD","madd2":"","madd3":"","mcity":"Naples","mstate":"ME","mzip":"04055","pcpfaxno":2076476015,"pcpnpi":1194801993,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2GN2VX4GW96","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79662","F339","M79602","M79605","W1849XA","E119","R0781","S81012A","E113293","G4700","Z043","M1712","M25462","M25572","M25562","R0782","D649","M810","L03116","S0285XA","S51012A","S61412A","S01112A","S0180XA","R0789","K449","Z7689","I739","S199XXA","E538","S6992XA","S59902A","S0990XA","E785","Z0000","H353132","E113393","M109","Z48812","S81802A","S61412S","R899","S41119A","T148XXA","N1830","Z780","Z23","L03114","M4156","M48061","G5602","S52502D"],"date":["2023-04-18","2024-09-12","2023-04-09","2023-04-09","2023-09-27","2025-08-12","2022-12-20","2023-04-09","2023-05-24","2024-11-18","2023-04-09","2024-04-23","2023-04-09","2024-11-18","2023-05-16","2022-11-28","2024-08-07","2025-09-22","2025-07-16","2023-09-27","2023-09-27","2023-09-27","2023-09-27","2025-05-21","2023-09-29","2023-09-29","2025-10-21","2025-10-22","2023-09-27","2025-02-19","2023-09-27","2023-09-27","2023-09-27","2023-08-04","2023-08-03","2025-07-03","2025-07-03","2023-08-09","2024-03-18","2025-06-06","2023-10-20","2023-01-03","2025-10-28","2025-11-03","2022-12-26","2025-09-22","2023-10-06","2023-09-29","2022-10-20","2022-10-05","2022-09-16","2022-08-08"],"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":[["","","METFORMIN HCL ER","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANC DEV","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","ONETOUCH ULTRA2","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","ONETOUCH ULTRASOFT 2 LANCET","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","ACCU-CHEK GUIDE ME GLUCOSE MTR","","","Select","Select",""],["","","ONETOUCH LANCETS","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","PRODIGY NO CODING","","","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":""}]}]}