{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kathy S Miller","gend":1,"currentgend":"","add":"15 WILD BERRY LN","city":"East Waterboro","state":"ME","zip":"04030","dob":"1950-11-21","age":"","mstatus":"","insh":"10000024702","cliId":"","pno":2072988986,"cno":"","email":"kmiller6@maine.rr.com","ename":"","eno":"","pphy":"RIDDLEBERGER, JAMES M","ppno":2078282402,"pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"15 WILD BERRY LN","madd2":"","madd3":"","mcity":"East Waterboro","mstate":"ME","mzip":"04030","pcpfaxno":2078282433,"pcpnpi":1114308277,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1X27TK2VH76","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":["M47812","M542","Z111","S199XXA","S0990XA","E1142","R8290","S060X0D","N3941","N3946","R301","N3281","E1140","E039","L97512","K2270","L603","M7989","L84","L97522","K219","Z1231","R059","M26629","M19071","L821","D225","L905","Z85828","R5383","Z1211","Z800","K5730","K635","R339","L03115","L02611","S81012A","S61217A","I10","S0003XA","S0101XA","W19XXXA","F418","M797","Z87891","L570","L708","R208","E119","N390","Z23","J323","R6889","Z0101","H524","H16223","D123","H10531","H5203","E11621","S8992XA","R159","Z7689","J45901","R918","F17200","M5030","M4802","L97911","L97921","N3000","H903","M79641","M19041","M25521","M779","W108XXA","H52223","S300XXA","S8991XA","S299XXA","R6884","I872","J45909","Z96653","J410","M25562","R799","T84023A","K5732","R933","M50322","F0781","Z96652","M151","M152","M79644"],"date":["2024-03-11","2025-06-21","2025-08-15","2025-06-21","2025-06-21","2025-11-17","2025-04-25","2025-07-24","2025-11-19","2022-12-19","2022-12-19","2025-11-19","2025-09-03","2025-06-18","2025-11-17","2025-06-18","2025-10-07","2025-06-21","2025-10-07","2025-07-29","2025-06-18","2024-12-09","2023-12-26","2024-10-14","2025-11-17","2025-07-21","2025-07-21","2025-07-21","2025-07-21","2023-03-30","2024-07-23","2024-07-23","2024-07-23","2024-07-23","2025-10-28","2025-09-18","2025-09-18","2023-07-05","2023-07-05","2025-06-21","2025-06-21","2025-06-21","2025-06-21","2025-10-15","2025-10-15","2025-10-15","2024-07-24","2023-07-19","2023-07-19","2025-08-13","2025-07-02","2025-10-06","2024-01-23","2022-12-14","2025-08-13","2025-08-13","2025-08-13","2024-07-23","2023-07-19","2023-07-19","2025-06-19","2025-06-21","2025-10-22","2025-10-22","2023-12-26","2023-07-13","2023-07-13","2024-03-11","2024-03-11","2025-06-19","2025-06-19","2025-07-02","2024-07-11","2024-07-12","2024-07-12","2024-07-12","2024-07-12","2025-06-21","2025-08-13","2025-06-21","2025-06-21","2025-06-21","2024-01-12","2025-06-18","2025-06-18","2022-11-15","2022-10-27","2022-10-27","2022-10-27","2022-10-14","2022-09-13","2022-09-13","2022-09-20","2022-08-24","2022-08-08","2022-08-08","2022-08-08","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":[["","","GABAPENTIN","","","Select","Select",""],["","","CLONIDINE HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","GLIMEPIRIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","INCRUSE ELLIPTA","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","TROSPIUM CHLORIDE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","SODIUM FLUORIDE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","CIPROFLOXACIN-DEXAMETHASONE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}