{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Janet L Roundy","gend":1,"currentgend":"","add":"18 CLEAVES ST","city":"Auburn","state":"ME","zip":"04210","dob":"1949-02-24","age":"","mstatus":"","insh":"10000033210","cliId":"","pno":2077839358,"cno":"","email":"","ename":"","eno":"","pphy":"LONGFELLOW, KAREN A","ppno":2075826608,"pcpadd":"44 MATHEWS AVE,","pcpcity":"WATERVILLE","pcpstate":"ME","pcpzip":"49015233","pcpcounty":"","pcpid":"","pcpname":"GARDINER FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"18 CLEAVES ST","madd2":"","madd3":"","mcity":"Auburn","mstate":"ME","mzip":"04210","pcpfaxno":"","pcpnpi":1295049187,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1K97D46PX46","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M170","M25561","G250","M5450","M79643","S62619A","L570","D485","L821","D1801","M25512","S62626A","M19041","M1991","Z85820","R059","M75102","S43432A","M25412","M19012","I10","Z87891","R10815","R110","R519","I129","S0990XA","D649","N189","M542","M461","N1830","Z0000","S62609A","S62629A","S060X0A","M25551","M85852","Z780","M47812","B854","M75122","R52","R109","M8580","N1831","E039","M75112","Z01419","Z1151","S60022A","Z0101","M9900","M9901","M9902","M1710","H25813","J0110","H05232","W01198A","S56112A","S3792XA","S0083XA","R251","K5900","M47816","M48061","M5126","M5136","H40013","H43813","M2550","M7542","E785","Z0001","G8929","L659","M62830","M1711","C4441","D492","L814","Z85828"],"date":["2025-04-16","2025-04-09","2024-03-05","2024-03-29","2025-06-26","2025-06-26","2025-09-10","2025-09-10","2025-09-10","2025-09-10","2023-07-13","2025-05-12","2025-05-07","2024-09-13","2023-09-06","2024-05-01","2023-03-21","2023-03-21","2023-03-21","2023-07-07","2025-11-04","2025-11-04","2025-08-19","2025-08-19","2025-05-21","2025-06-17","2025-06-24","2025-08-26","2025-05-24","2025-10-15","2024-03-04","2025-03-04","2023-10-12","2025-05-22","2025-05-22","2025-06-24","2023-11-13","2025-01-21","2025-01-21","2025-07-30","2024-07-14","2023-02-27","2023-02-27","2025-06-06","2025-03-27","2025-08-26","2025-08-26","2023-07-07","2023-11-08","2023-11-08","2025-06-24","2023-10-03","2025-03-27","2025-03-27","2025-03-27","2024-09-06","2025-10-07","2024-03-22","2025-06-22","2025-06-22","2025-06-24","2025-06-24","2025-06-24","2023-08-18","2023-08-18","2023-12-18","2023-12-18","2023-12-18","2023-12-18","2024-10-04","2024-10-04","2025-06-19","2022-12-19","2025-03-04","2024-12-02","2022-10-25","2022-11-10","2022-09-27","2022-09-27","2022-09-06","2022-09-06","2022-09-06","2022-09-06"],"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":[["","","ATENOLOL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CELECOXIB","","","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":""}]}]}