{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Catherine A Bean","gend":1,"currentgend":"","add":"48 CLINTON ST","city":"South Portland","state":"ME","zip":"04106","dob":"1947-08-11","age":"","mstatus":"","insh":"10000022766","cliId":"","pno":2077672465,"cno":"","email":"cbean1@maine.rr.com","ename":"","eno":"","pphy":"EDWARDS, STEVEN R","ppno":2077998596,"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":"48 CLINTON ST","madd2":"","madd3":"","mcity":"South Portland","mstate":"ME","mzip":"04106","pcpfaxno":2078287850,"pcpnpi":1710177936,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1MX9MY2KW44","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":["M170","I5032","N390","L97822","D649","E785","R7309","R300","R2681","M25462","M1712","M7122","J8489","R918","R0609","Z23","M059","Z7952","Z79899","M064","M25511","B9620","U071","R600","Z09","Z872","R059","R109","I4820","Z7901","I110","I4819","N200","L97829","N201","L97819","E6601","Z6843","J9811","I517","I4891","R760","M7910","M129","I10","F4321","M1990","E8342","M179","K5900","Z1231","Z0100","M6281","K5730","M79602","R319","R931","J849","F419","M25561","R2689","M353","L97919","I2510","M25512","M25562","M25569","Z7409","M19011","M85811","S46011A","Z1211","Z86010","D122","D123","D124","K562","D125"],"date":["2023-06-30","2025-06-20","2023-10-27","2023-07-05","2025-02-05","2024-08-05","2024-08-05","2024-11-18","2023-10-09","2022-12-27","2023-01-20","2022-12-27","2024-07-26","2024-07-26","2024-07-26","2025-10-25","2025-06-06","2025-06-06","2025-06-24","2023-11-03","2023-06-29","2022-12-28","2023-01-10","2023-07-12","2023-07-12","2023-07-12","2024-01-17","2024-08-05","2024-08-16","2024-08-16","2025-06-20","2024-04-11","2025-08-25","2023-06-05","2025-01-21","2023-06-08","2023-06-08","2023-06-08","2024-03-07","2024-06-24","2024-12-19","2023-03-08","2023-03-08","2023-03-08","2023-09-20","2023-03-30","2023-03-23","2023-04-18","2023-03-08","2023-03-02","2024-03-05","2025-06-24","2023-02-27","2024-08-26","2023-05-10","2024-08-28","2023-09-20","2024-01-17","2023-03-23","2023-01-17","2023-03-01","2023-01-17","2023-06-15","2024-06-24","2022-12-12","2022-12-26","2022-12-26","2022-12-26","2022-11-22","2022-11-22","2022-11-22","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23","2022-09-23"],"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":[["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","BUMETANIDE","","","Select","Select",""],["","","LEFLUNOMIDE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","CELECOXIB","","","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":""}]}]}