{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jean A Mclaughlin","gend":1,"currentgend":"","add":"30 SOUTH ST APT G","city":"Saco","state":"ME","zip":"04072","dob":"1940-04-25","age":"","mstatus":"","insh":"10000028531","cliId":"","pno":2072824483,"cno":"","email":"","ename":"","eno":"","pphy":"STEELE, ERIK N","ppno":"","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":"30 SOUTH ST APT G","madd2":"","madd3":"","mcity":"Saco","mstate":"ME","mzip":"04072","pcpfaxno":2078287850,"pcpnpi":1538176789,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3XR6F28EP43","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J9600","J9601","I480","R222","M549","E876","R55","R42","R000","N390","F419","N3000","Z0000","E039","Z9181","J8410","I2510","I10","D649","J441","R059","R112","R197","R109","M5450","S199XXA","S0990XA","S79911A","R918","R0602","R071","I080","R1110","J849","J449","N3001","K5900","F10120","R011","K5730","R531","A401","M47816","M48061","J479","D720","M25551","R4182","M51360","Z515","R079","S0993XA","Z20822","W19XXXA","Y92009","R0600","I499","A419","S90569A","R5383","G8929","Z889","Z79899","M47896","M2550","K8020","M546","M150","M25512","R634","S3991XA","S3993XA","S299XXA","L819","I110","E119","G44229","Z0100","I959","S00431A","E860","A084","R413","W57XXXA","L209","R410","R002","Z7901","B951","R350","R110","R3915"],"date":["2024-11-18","2024-11-17","2024-07-11","2025-01-21","2025-05-20","2025-09-08","2024-04-11","2024-03-09","2023-02-15","2025-09-08","2022-12-21","2022-12-06","2024-04-11","2025-06-04","2024-04-11","2024-11-11","2025-06-04","2025-06-04","2025-06-04","2025-02-17","2024-11-11","2025-08-20","2023-10-31","2023-10-28","2025-05-20","2024-05-31","2024-05-31","2024-06-01","2023-10-28","2024-11-11","2024-11-11","2024-03-09","2024-11-09","2025-08-20","2024-11-19","2025-09-08","2024-06-08","2024-05-31","2024-05-31","2025-08-20","2024-11-11","2025-08-20","2025-08-03","2023-12-28","2024-11-11","2023-07-06","2024-06-01","2024-06-03","2025-03-29","2025-09-12","2023-11-01","2024-03-08","2024-11-05","2024-03-09","2024-03-09","2023-02-15","2025-08-21","2025-08-20","2024-01-04","2024-02-01","2025-05-20","2025-05-20","2025-05-20","2025-05-05","2023-04-06","2025-08-20","2025-05-20","2023-07-31","2024-12-08","2023-02-10","2024-05-29","2024-05-29","2024-05-29","2024-02-01","2024-05-07","2024-05-07","2024-05-07","2024-12-18","2023-08-27","2024-05-29","2023-08-27","2023-02-16","2024-01-11","2024-01-11","2024-01-11","2024-03-08","2023-02-18","2023-02-15","2022-12-06","2022-12-05","2022-12-05","2022-12-05"],"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",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","VERAPAMIL ER PM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","LEVOCETIRIZINE DIHYDROCHLORIDE","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","DESOXIMETASONE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","NEXIUM","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","BREO ELLIPTA","","","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":""}]}]}