{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Darlene Pendleton","gend":1,"currentgend":"","add":"28 TARYN DR","city":"DRESDEN","state":"ME","zip":"04342","dob":"1950-03-01","age":"","mstatus":"","insh":"10000039745","cliId":"","pno":2077374528,"cno":"","email":"Elderberry16@outlook.com","ename":"","eno":"","pphy":"HOKE, ABIGAIL","ppno":2075826608,"pcpadd":"Gardiner Family Medicine,5 Central Maine Crossing","pcpcity":"Gardiner","pcpstate":"ME","pcpzip":"04345","pcpcounty":"","pcpid":"","pcpname":"GARDINER FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"28 TARYN DR","madd2":"","madd3":"","mcity":"DRESDEN","mstate":"ME","mzip":"04342","pcpfaxno":2075822258,"pcpnpi":1740576495,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8KF6QD7HX81","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R899","F331","R42","Z0000","F320","I2510","F419","F411","R053","J479","R1310","R6889","I10","E7800","R0789","D225","L821","D1801","L814","B079","Z1231","M25512","D3500","T691XXA","Z0001","J029","R0982","H73893","Z87891","M79645","H26493","R002","Z0101","E039","E278","K8689","N854","Z13820","D3501","M8580","H5310","J329","M7711","S30861A","H43812","H31091","H43391","J310","E854","G43009","I680","R079","H43811","H538","Z23","W57XXXA","H532","R270","G43711","D72819","I4710","I493","I498","Z1211","S6992XA","M8589","Z780","I499","G43909","G43809","M79674","R413","E785","M7989","X500XXA","R059","D3502","R499","R0600","Z20822"],"date":["2023-01-05","2024-07-26","2025-09-17","2024-01-12","2025-02-04","2025-10-20","2025-02-04","2025-11-10","2025-06-09","2025-06-09","2025-07-01","2023-11-09","2024-03-26","2025-02-17","2023-12-04","2025-01-29","2025-01-29","2025-01-29","2025-01-29","2025-01-29","2024-04-26","2025-01-08","2025-09-03","2023-01-11","2025-02-04","2025-10-01","2023-04-05","2023-04-05","2025-10-01","2024-03-25","2023-03-09","2025-03-18","2024-04-25","2025-03-14","2022-11-28","2022-11-28","2022-11-28","2023-11-09","2022-11-28","2023-03-07","2023-03-07","2023-08-30","2024-04-17","2025-04-25","2023-09-01","2023-07-31","2023-07-31","2023-04-24","2025-03-05","2025-10-07","2025-03-05","2025-03-05","2023-06-08","2023-06-08","2024-11-21","2025-04-25","2025-07-17","2025-02-22","2025-01-22","2023-01-25","2025-03-20","2023-10-04","2025-03-20","2023-04-24","2023-05-02","2023-11-09","2023-11-09","2023-07-24","2024-09-03","2024-09-03","2023-01-17","2023-02-16","2023-08-30","2023-05-02","2023-05-02","2022-11-04","2022-10-28","2022-11-14","2022-10-03","2022-10-03"],"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":[["","","REPATHA SURECLICK","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","BEVESPI AEROSPHERE","","","Select","Select",""],["","","INCRUSE ELLIPTA","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","TOPIRAMATE","","","Select","Select",""],["","","PRALUENT PEN","","","Select","Select",""],["","","DULERA","","","Select","Select",""],["","","ARNUITY ELLIPTA","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","CLOTRIMAZOLE","","","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":""}]}]}