{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Madalienne L Rowell","gend":1,"currentgend":"","add":"29 BOYLE RD","city":"Freeport","state":"ME","zip":"04032","dob":"1949-01-06","age":"","mstatus":"","insh":"10000033565","cliId":"","pno":2078381190,"cno":"","email":"MADDYR67@ICLOUD.COM","ename":"","eno":"","pphy":"WADLAND, WILLIAM R","ppno":2078282402,"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":2078695312,"add2":"","add3":"","madd1":"29 BOYLE RD","madd2":"","madd3":"","mcity":"Freeport","mstate":"ME","mzip":"04032","pcpfaxno":2078287850,"pcpnpi":1154499002,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8CR5HP8MD93","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":["R42","R2689","N200","E119","G4733","G4710","R109","Z1231","M899","S2241XA","H25813","I6523","R0989","D123","Z86010","K5730","H81392","H40033","K5900","H5203","Z23","H2513","R011","H81399","E785","H903","N644","I080","R928","Z13820","H938X1","M7989","M25551","H6983","I499","S299XXA","D485","H04123","M19072","M2410","H524","L739","R6889","M25522","R309","Z0101","M6210"],"date":["2024-07-15","2024-06-13","2025-06-26","2025-11-04","2025-10-22","2025-10-22","2023-03-28","2025-11-04","2025-10-22","2025-08-21","2022-11-30","2024-11-20","2024-11-20","2024-01-18","2024-01-18","2024-01-18","2025-06-07","2024-12-03","2025-06-26","2023-11-28","2025-09-19","2024-12-03","2025-04-02","2025-06-07","2024-03-29","2025-09-30","2023-09-20","2025-04-02","2023-09-20","2025-11-03","2024-07-15","2023-03-22","2023-03-22","2024-04-26","2025-06-08","2025-08-21","2023-11-06","2022-11-30","2023-03-22","2025-07-14","2024-12-03","2023-11-06","2022-05-12","2022-09-02","2022-03-23","2021-11-09","2022-02-16"],"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":[["","","METFORMIN HCL ER","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","CLINPRO 5000","","","Select","Select",""],["","","POTASSIUM CITRATE ER","","","Select","Select",""],["","","FLUARIX QUAD 2022-2023","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}