{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Judy S Kagiliery","gend":1,"currentgend":"","add":"33 OLD KINGS HWY","city":"OGUNQUIT","state":"ME","zip":"03907","dob":"1946-12-06","age":"","mstatus":"","insh":"10000026877","cliId":"","pno":2074754981,"cno":"","email":"bigkag@comcast.net","ename":"","eno":"","pphy":"ADAMS, TODD","ppno":2076468386,"pcpadd":"York Hospital Internal Medicine of York,277 Post Rd","pcpcity":"Moody","pcpstate":"ME","pcpzip":"04054","pcpcounty":"","pcpid":"","pcpname":"WEBHANNET INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"33 OLD KINGS HIGHWAY","madd2":"","madd3":"","mcity":"OGUNQUIT","mstate":"ME","mzip":"03907","pcpfaxno":2076412855,"pcpnpi":1427165778,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2D24XF6DX89","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K921","M8588","K2211","F458","K219","R0781","S42202A","L539","S299XXA","R079","S199XXA","S0990XA","S2243XA","G8929","D649","I82442","E039","S2243XD","G8911","R2689","F419","S8992XA","Z96652","Z471","I2694","S42242D","R1310","M25512","W19XXXA","S4992XS","N6331","F418","D181","K922","K5900","J90","Z0000","I82402","R051","K449","Z1231","M810","M85832","D62","S42232K","S2249XA","R2231","Z4789","J9811","K920","K2100","K7581","H5310","H43813","H52223","S42212D","M79602","S42242A","S42202D","M5134","R0602","R42","S79922A","S8991XA","S99922A","S2239XA","R0989","D500","K317","K760","S42232A","S42212A","D225","L821","L814","L720","K2090","R0902","S32010D","G8918","K2289","R1314","T148XXA","S42292D","S59901A","M7989","R9389","S3991XA","S3993XA","R918","M5450","S42202S","J929","I517","S2241XA","I2699","I2510","C50911","H6992","L03032","W010XXD","L820","Z789","R58","L538"],"date":["2025-07-21","2025-10-27","2024-02-21","2025-07-28","2025-09-30","2025-04-03","2025-07-01","2023-06-28","2022-12-21","2022-12-21","2022-12-21","2022-12-21","2023-01-13","2022-12-30","2025-09-27","2023-01-10","2025-10-23","2023-02-12","2023-01-09","2023-01-09","2023-01-01","2022-12-21","2022-12-21","2022-12-21","2025-07-17","2025-11-03","2025-09-30","2025-06-27","2025-05-29","2025-05-29","2025-09-03","2024-05-02","2025-10-01","2025-09-04","2022-12-27","2022-12-29","2025-09-24","2022-12-29","2025-07-14","2025-09-30","2024-09-11","2025-10-27","2025-10-27","2025-07-21","2025-06-30","2022-12-22","2025-09-12","2025-07-11","2022-12-29","2024-02-13","2025-09-30","2024-02-11","2024-07-16","2024-07-16","2024-07-30","2025-08-05","2025-06-27","2025-07-01","2025-08-18","2024-05-06","2025-09-24","2023-03-23","2022-12-21","2022-12-21","2022-12-21","2022-12-22","2022-12-22","2025-09-30","2025-09-30","2025-08-22","2025-07-01","2025-05-29","2024-09-24","2024-09-24","2024-09-24","2024-09-24","2024-04-02","2022-12-22","2023-10-04","2025-07-01","2025-09-30","2025-09-30","2025-05-29","2025-06-06","2022-12-26","2022-12-26","2022-12-24","2022-12-21","2022-12-21","2022-12-26","2023-09-13","2025-06-27","2022-12-24","2022-12-24","2022-12-28","2025-07-17","2025-07-17","2024-08-24","2023-03-12","2023-06-21","2023-09-13","2022-06-14","2022-06-14","2022-06-14","2022-06-14"],"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":[["","","DULOXETINE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","METHOCARBAMOL","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","PFIZER COVID (12Y UP) VAC(EUA)","","","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":""}]}]}