{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Roxy A Getchell","gend":1,"currentgend":"","add":"3149 MIDDLE RD","city":"AUGUSTA","state":"ME","zip":"04330","dob":"1944-12-03","age":"","mstatus":"","insh":"10000028651","cliId":"","pno":2074856776,"cno":"","email":"mysticmequilts@aol.com","ename":"","eno":"","pphy":"KUHL, AMY M","ppno":"","pcpadd":"Inland Family Care Waterville,16 Concouse W","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"00000","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT PRIMARY CARE DOWNTOWN WATERVILLE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3149 MIDDLE RD","madd2":"","madd3":"","mcity":"AUGUSTA","mstate":"ME","mzip":"04330","pcpfaxno":2079735042,"pcpnpi":1366715302,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5XT0GJ6MH09","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M7632","Z96653","R3989","Z1231","M76892","M769","Z0000","M5416","M4316","M47816","H5203","H52223","H524","R319","E559","G8929","M48061","M4726","G5732","M9905","M461","M9904","M7918","N390","M5450","G5782","G588","M160","M25561","M25562","R310","Z87440","M5417","R6889","M4310","E6601","K922","I10","E785","M7989","I878","Z79899","G894","M5116","M1610","E669","R7303","M25569","Z96652","Z96651","Z5189","Z01818","K921","Z780","Z23","G6289","G5702","G5783","Z471","K5790","Z0001","E039"],"date":["2024-10-21","2024-10-21","2023-04-05","2023-06-08","2024-10-21","2024-05-09","2025-05-27","2024-05-30","2024-07-08","2025-02-05","2024-05-23","2024-05-23","2024-05-23","2023-05-16","2024-10-03","2024-10-21","2024-03-12","2024-03-12","2024-05-06","2023-06-14","2023-06-14","2023-06-14","2023-06-14","2023-05-16","2023-08-11","2023-09-29","2023-09-29","2023-09-29","2023-12-01","2024-01-29","2023-05-15","2023-05-15","2023-08-24","2023-08-25","2023-08-11","2023-08-11","2024-12-26","2023-03-16","2022-10-07","2022-10-07","2022-10-07","2025-03-03","2025-03-03","2023-04-25","2023-09-19","2023-11-07","2023-09-19","2023-11-02","2023-12-01","2023-12-01","2023-09-05","2024-11-14","2024-12-26","2023-06-08","2024-11-04","2024-09-25","2024-08-26","2023-12-11","2023-12-01","2025-03-03","2023-05-16","2022-07-21"],"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":[["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","KLAYESTA","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","BUPRENORPHINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","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":""}]}]}