{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cindy L Mackie","gend":1,"currentgend":"","add":"29 STONERIDGE CIR","city":"Standish","state":"ME","zip":"04084","dob":"1951-11-26","age":"","mstatus":"","insh":"10000030717","cliId":"","pno":2075919195,"cno":"","email":"","ename":"","eno":"","pphy":"FAY SHIELDS, JACOB A","ppno":2078392559,"pcpadd":"Martins Point Health Care,575 Main St","pcpcity":"Gorham","pcpstate":"ME","pcpzip":"04038","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"29 STONERIDGE CIR","madd2":"","madd3":"","mcity":"Standish","mstate":"ME","mzip":"04084","pcpfaxno":2075231135,"pcpnpi":1467038042,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2V90AD6RR01","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":["E119","H16223","R945","I2510","I252","I10","E785","I083","R1032","S46812A","R079","N762","H04123","Z1389","N6310","Z0101","I214","R0789","W010XXA","R1011","R413","R002","R0601","E1165","K5730","K760","N6452","Z794","R0683","R2689","R4189","N6489","K862","N6311","L723","R928","R922","Z1231","M25511","Z23","R160","N6001","R1012","E8801","R110","R42","M25561","D509","Z955","E236","M19031","M7631","G8929","M7632","F419","N958","R410","D72820","R5383","M7541","R519","M19041","M25562","R112","E0590","H1033","Z961","Z13820","M1811","Z711","W57XXXA","E781","M19039"],"date":["2025-07-16","2023-10-18","2024-11-06","2025-08-24","2025-08-22","2025-08-22","2025-08-22","2025-07-10","2024-11-22","2023-12-26","2025-07-12","2023-04-13","2023-03-02","2024-01-02","2023-05-22","2024-05-21","2025-07-16","2023-07-24","2024-02-06","2023-08-22","2024-12-06","2025-02-01","2025-08-22","2023-07-24","2024-01-02","2024-01-02","2023-05-03","2025-07-16","2023-03-21","2025-03-13","2025-03-13","2023-12-29","2023-08-22","2023-05-15","2023-05-15","2023-12-29","2023-05-03","2025-01-21","2023-08-23","2022-11-28","2023-01-02","2023-05-03","2023-09-21","2023-09-21","2024-10-22","2024-11-26","2023-11-08","2022-12-20","2025-07-18","2024-02-05","2023-08-23","2023-11-08","2023-11-08","2023-02-01","2025-07-09","2023-05-23","2024-11-22","2024-10-22","2023-04-24","2023-08-23","2022-11-03","2022-11-22","2022-11-22","2022-11-03","2022-11-21","2022-10-07","2022-10-17","2022-09-22","2022-09-20","2022-08-10","2022-08-10","2022-08-10","2022-08-11"],"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":[["","","VICTOZA 2-PAK","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TICAGRELOR","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","CLONIDINE HCL","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ACYCLOVIR","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","GLIPIZIDE","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","FLUOROMETHOLONE","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","ALREX","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","ARNUITY ELLIPTA","","","Select","Select",""],["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","TRETINOIN","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","NEXLETOL","","","Select","Select",""],["","","NEXLIZET","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ULTRA-FINE SHORT PEN NEEDLE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","FLOVENT HFA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}