{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Catherine E Colby","gend":1,"currentgend":"","add":"44 SHAW RD","city":"New Gloucester","state":"ME","zip":"04260","dob":"1948-08-22","age":"","mstatus":"","insh":"10000037138","cliId":"","pno":2079264217,"cno":"","email":"kathycolby@maine.rr.com","ename":"","eno":"","pphy":"SKELTON, SARAH K","ppno":2077847388,"pcpadd":"Family Health Care Associates,190 Stetson Rd","pcpcity":"Auburn","pcpstate":"ME","pcpzip":"04210","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2075775182,"add2":"","add3":"","madd1":"44 SHAW RD","madd2":"","madd3":"","mcity":"New Gloucester","mstate":"ME","mzip":"04260","pcpfaxno":2077952043,"pcpnpi":1861489882,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9NV8HN8TE20","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0389","I2510","E119","R5383","I10","I214","Z1231","K8020","K651","K8064","Z0101","E1159","Z9841","Z9842","K812","Z0000","T8143XA","F419","Z466","K8510","E785","K8309","R079","Z7984","R000","R109","R7401","E806","R270","R1031","R059","R112","R0789","K828","K810","I340","K8590","R4182","G9389","R9089","R1084","R1110","K8050","H6123","Z95828"],"date":["2024-12-14","2025-09-08","2025-09-02","2024-08-28","2025-09-08","2024-08-08","2025-04-02","2025-01-15","2025-09-08","2025-02-07","2025-02-24","2025-09-08","2025-02-24","2025-02-24","2025-01-10","2025-03-04","2025-09-02","2024-08-21","2025-01-03","2025-01-03","2025-03-04","2024-04-07","2024-06-11","2023-02-21","2024-04-05","2024-06-11","2024-04-05","2024-04-05","2023-08-23","2025-07-26","2024-06-11","2024-06-11","2024-06-11","2024-04-05","2024-06-13","2024-06-12","2024-06-11","2023-08-23","2023-08-23","2023-08-23","2025-07-26","2025-07-26","2024-06-11","2025-07-24","2024-12-14"],"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","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ACCU-CHEK GUIDE TEST STRIP","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ACCU-CHEK GUIDE MONITOR SYSTEM","","","Select","Select",""],["","","SHINGRIX","","","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":{"indx":[],"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":""}]}]}