{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara L Zepp","gend":1,"currentgend":"","add":"8 RIVERBEND DR","city":"GUILFORD","state":"ME","zip":"04443","dob":"1944-08-17","age":"","mstatus":"","insh":"10000026347","cliId":"","pno":"","cno":2072493773,"email":"barbarazepp@gmail.com","ename":"","eno":"","pphy":"MACDONALD, MICHAEL C","ppno":2073736848,"pcpadd":"22 STATION AVE,SUITE 101","pcpcity":"BRUNSWICK","pcpstate":"ME","pcpzip":"40112092","pcpcounty":"","pcpid":"","pcpname":"SEBASTICOOK FAMILY DOCTORS","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"8 RIVERBEND DR","madd2":"","madd3":"","mcity":"GUILFORD","mstate":"ME","mzip":"04443","pcpfaxno":2073736849,"pcpnpi":1235220740,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2YR6AJ5AV60","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N200","E119","R310","Z87442","N132","N281","R6889","H40023","K5900","Z0101","H524","H2513","H401113","E118","H04123","E559","H401131","R109","E782","I10","N2889","J029","R1084","N289","Z436","I878","R809"],"date":["2025-09-10","2024-04-18","2024-12-22","2025-09-10","2024-10-08","2024-12-22","2022-12-27","2023-03-30","2024-12-22","2022-12-22","2025-03-18","2022-12-22","2025-08-27","2023-12-28","2024-01-19","2024-04-18","2023-07-25","2025-09-10","2024-04-25","2025-04-22","2023-06-06","2024-02-27","2024-08-18","2024-08-18","2024-12-13","2024-06-03","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":[["","","LATANOPROST","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","LUMIGAN","","","Select","Select",""],["","","TIMOLOL MALEATE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","FENOFIBRATE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","PENICILLIN V POTASSIUM","","","Select","Select",""],["","","EPINEPHRINE","","","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":""}]}]}