{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary E York","gend":1,"currentgend":"","add":"4 WESSON WAY","city":"Windham","state":"ME","zip":"04062","dob":"1972-06-23","age":"","mstatus":"","insh":"10000033416","cliId":"","pno":2073299420,"cno":"","email":"yorkiem23@gmail.com","ename":"","eno":"","pphy":"LETELLIER, TERESA","ppno":2072831441,"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 WESSON WAY","madd2":"","madd3":"","mcity":"Windham","mstate":"ME","mzip":"04062","pcpfaxno":2075231136,"pcpnpi":1629431622,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7K57NY0KY43","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":["R928","S42322A","M5416","Z1231","G5632","M461","N6091","R920","M7918","M25552","S0100XA","S42302A","Z87891","M47816","M4316","G6289","M5116","M48061","Z01818","R92333","Z96611","R109","M5450","S42321D","M19011","Z98890","Z1211","D120","K219","E669","Z981","R6889","S8391XA","K838","F418","J45909","S299XXA","S3991XA","S3993XA","S0990XA","S199XXA","S42332A","S83241A","K8050","S8991XA","M1611","R921","L299","D729","Z8781","M549","L729","M5442","M5136","Z5189","K810","R4182","K8000","G8918","M79622","W108XXA","N6315","K5900","N200","R030","T8189XA","K668","K9189","X58XXXA","K5730","R7401","M51360","Z9049","Z4789","G4730","M47896","E785","I10","S42322D","Z6834","M25511"],"date":["2025-04-07","2025-02-26","2025-05-30","2025-03-19","2025-06-11","2024-12-17","2025-04-07","2025-04-07","2024-01-02","2024-01-02","2025-03-01","2025-02-22","2025-02-22","2025-10-07","2025-10-07","2025-06-11","2023-01-11","2025-05-01","2023-01-12","2025-04-07","2023-04-25","2024-05-20","2025-03-24","2025-03-28","2023-04-18","2025-10-07","2024-09-13","2024-09-13","2025-05-01","2024-09-13","2025-07-09","2023-09-04","2023-11-09","2024-05-20","2024-05-20","2025-02-26","2025-02-22","2025-02-22","2025-02-22","2025-02-22","2025-02-22","2025-02-24","2023-11-16","2024-05-20","2023-11-16","2025-01-31","2025-03-25","2024-10-03","2024-10-03","2025-08-22","2024-04-20","2025-02-20","2023-09-15","2023-09-15","2025-05-12","2024-04-20","2024-04-20","2024-04-20","2025-02-26","2025-02-22","2025-02-22","2025-04-21","2024-04-19","2024-04-19","2023-06-10","2024-04-26","2024-04-26","2024-04-26","2025-02-26","2024-04-25","2024-04-26","2025-05-01","2024-05-14","2025-08-22","2025-11-12","2025-05-01","2025-05-01","2025-05-01","2025-05-05","2023-01-19","2022-11-05"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","DEXAMETHASONE","","","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":""}]}]}