{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Noreen A Graham","gend":1,"currentgend":"","add":"100 MASARDIS RD","city":"ASHLAND","state":"ME","zip":"04732","dob":"1949-11-17","age":"","mstatus":"","insh":"10000035750","cliId":"","pno":2074356029,"cno":"","email":"declined@03242025.com","ename":"","eno":"","pphy":"GROVER, ELEANOR V","ppno":2077647200,"pcpadd":"\tFull Circle Health Care,169 Academy St Ste C","pcpcity":"Presque Isle","pcpstate":"ME","pcpzip":"04769","pcpcounty":"","pcpid":"","pcpname":"FULL CIRCLE HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"100 MASARDIS RD","madd2":"","madd3":"","mcity":"ASHLAND","mstate":"ME","mzip":"04732","pcpfaxno":2077647204,"pcpnpi":1730191172,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8TP8MT8UM39","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E039","I10","I4891","K642","K219","M1990","H35372","H35371","H2513","H35373","H33321","H04123","E782","K2100","Z0000","K6289","R300","R7309","M25519","N816","K5900","H8110","H43812","G5603","R079","M542","M25512","Z7901","Z1231","R9431","E785","Z48815","H25812","H3581","H43813","I4820","I483","I2109","H25811","H25813","K644","R92323","Z780","M8589","R350","N390","R809","G5613","Z0101","H524","H52223"],"date":["2025-08-14","2025-09-27","2025-08-30","2024-03-04","2024-03-04","2025-06-28","2025-05-19","2025-05-19","2024-04-08","2025-02-10","2023-09-08","2024-04-08","2025-09-27","2025-04-01","2025-02-18","2024-03-18","2025-07-07","2025-08-06","2025-08-14","2023-07-27","2023-07-27","2024-09-05","2024-04-08","2024-07-23","2023-08-11","2023-09-08","2023-09-08","2023-01-06","2025-05-20","2023-05-16","2023-05-16","2024-03-28","2024-12-18","2025-03-03","2025-05-22","2025-01-16","2023-08-11","2025-01-16","2024-11-27","2024-11-27","2023-11-21","2025-05-20","2025-03-27","2025-03-27","2025-07-07","2025-07-07","2025-09-27","2024-07-23","2025-05-22","2025-05-22","2025-05-22"],"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":[["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","TRIMETHOPRIM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","DILT-XR","","","Select","Select",""],["","","SYNTHROID","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","DILTIAZEM 24HR ER (XR)","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","WARFARIN SODIUM","","","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":""}]}]}