{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lisbeth A Nadeau","gend":1,"currentgend":"","add":"4 SUMAC DR","city":"Brunswick","state":"ME","zip":"04011","dob":"1945-07-04","age":"","mstatus":"","insh":"10000030998","cliId":"","pno":2078415810,"cno":"","email":"BETH.NADEAU@COMCAST.NET","ename":"","eno":"","pphy":"WHITE, SARAH B","ppno":2077984400,"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":"4 SUMAC DR","madd2":"","madd3":"","mcity":"Brunswick","mstate":"ME","mzip":"04011","pcpfaxno":"","pcpnpi":1063702819,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2MV7VQ7TV71","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":["Z1211","R300","M7061","H16143","M9904","M461","M9903","M5450","N390","R21","G44319","I83812","I83892","L900","N905","L209","H1132","Z23","M1611","I83891","I83811","R262","M79671","Z961","R6889","I83813","I83893","M47812","M5030","N898","I480","I10","Z1231","L309","M722","E039","S0990XA","I358","N3001","R399","N904","N952","Z90710","L308","Z0101","Z1279","Z1389","E7800","R7303","R52","E538","E669","S0003XA","M542","H2511","H2512","H259","N6315","N6001","R928","N644","R922"],"date":["2024-04-25","2024-02-12","2024-10-22","2025-03-20","2025-11-13","2025-11-13","2025-11-13","2025-11-13","2025-07-28","2023-09-15","2024-02-16","2025-03-26","2025-03-26","2024-08-21","2024-08-21","2024-06-12","2025-03-20","2025-10-02","2024-10-22","2023-07-13","2023-07-13","2024-11-21","2025-06-18","2025-05-13","2023-10-14","2025-08-25","2025-08-25","2024-02-16","2024-02-16","2023-10-30","2025-02-10","2025-10-29","2024-09-18","2024-08-21","2025-06-18","2025-09-30","2024-02-16","2025-10-30","2025-05-15","2025-07-28","2024-04-22","2023-10-04","2023-10-04","2023-10-04","2025-05-13","2024-09-18","2024-09-18","2025-09-30","2023-10-02","2024-10-15","2025-09-30","2024-10-18","2024-02-16","2024-02-16","2022-11-22","2022-11-15","2022-11-22","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-09-22"],"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":[["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","PREMARIN","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","TERCONAZOLE","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","PIMECROLIMUS","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","EUTHYROX","","","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":""}]}]}