{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Valerie J Rice","gend":1,"currentgend":"","add":"924 TUNK LAKE RD","city":"Sullivan","state":"ME","zip":"04664","dob":"1946-06-08","age":"","mstatus":"","insh":"10000039405","cliId":"","pno":2074222030,"cno":"","email":"declined@040320.com","ename":"","eno":"","pphy":"HANSON, CASEY S","ppno":2076675899,"pcpadd":"PO BOX 8,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46090008","pcpcounty":"","pcpid":"","pcpname":"TRENTON HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"924 TUNK LAKE RD","madd2":"","madd3":"","mcity":"Sullivan","mstate":"ME","mzip":"04664","pcpfaxno":2078015123,"pcpnpi":1164536397,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3KU0X38MN24","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J449","J9621","M1611","I77819","R768","I110","I2510","I5030","I10","R42","R0602","I509","I4891","N6021","N6489","G4733","I2720","G4736","I493","E1165","E6601","M25552","E1142","D485","L570","L814","D1801","L821","Z7189","R9431","E119","M7531","Z1231","Z5189","Z79899","Z0101","H5213","Z515","R928","M5459","M9903","M9902","M546","D2272","Z0000","S0096XA","S30860A","I480","R600","R079","J90","J811","I081","N6311","G4730","E133213","M19012","M25512","H52223","M85852","Z13820","M62838","R197","D225","L98491"],"date":["2025-09-09","2025-09-09","2023-09-08","2024-06-26","2025-01-24","2024-03-08","2025-05-02","2025-01-31","2025-01-31","2024-02-05","2024-02-05","2025-04-30","2025-03-17","2022-12-15","2022-12-15","2025-04-30","2025-04-30","2024-02-24","2024-02-24","2024-09-19","2025-06-12","2024-01-17","2025-04-15","2024-08-07","2025-04-24","2025-04-24","2024-08-07","2025-04-24","2025-04-24","2023-02-06","2025-06-12","2025-02-04","2022-10-17","2024-05-06","2023-02-02","2025-09-04","2024-08-30","2024-08-15","2022-11-15","2023-10-06","2023-10-06","2023-10-06","2023-10-06","2024-08-07","2024-09-16","2024-10-30","2024-06-17","2024-10-07","2024-02-06","2024-02-05","2024-02-06","2024-02-06","2024-02-06","2022-12-15","2023-08-07","2023-08-21","2025-08-28","2025-08-28","2025-09-04","2024-10-25","2024-10-25","2024-10-09","2023-02-17","2025-04-24","2022-08-22"],"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":[["","","METFORMIN HCL ER","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","TRUE METRIX GLUCOSE TEST STRIP","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","INSULIN GLARGINE SOLOSTAR","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","ULTRA-FINE NANO PEN NEEDLE","","","Select","Select",""],["","","ULTRA-FINE MICRO PEN NEEDLE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","GLIPIZIDE","","","Select","Select",""],["","","MYRBETRIQ","","","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":""}]}]}