{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karen J Pierson","gend":1,"currentgend":"","add":"552 PARK ST","city":"Livermore Falls","state":"ME","zip":"04254","dob":"1950-03-21","age":"","mstatus":"","insh":"10000040588","cliId":"","pno":2078970975,"cno":"","email":"Karenjoyp.3@gmail.com","ename":"","eno":"","pphy":"DECKER, HEIDI C","ppno":2078976601,"pcpadd":"21 MAIN ST,FRANKLIN HEALTH LIVERMORE FALLS FAMILY PRACTICE","pcpcity":"LIVERMORE FALLS","pcpstate":"ME","pcpzip":"42541219","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2073577001,"add2":"","add3":"","madd1":"552 PARK ST","madd2":"","madd3":"","mcity":"Livermore Falls","mstate":"ME","mzip":"04254","pcpfaxno":2078974339,"pcpnpi":1720068240,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3YX9MT4AP30","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E7800","M85852","Z780","F324","R350","K429","J45909","F32A","E785","Z0100","Z13820","E119","Z01818","M25512","K436","R1010","Z9049","Z23","R5382","Z0000","D124","D125","R059","Z1231","I491","Z1211","K5730","R030","R3129","N1831","E1122","R221","N3289","R319","E7849","R7303","F325","M25511","J4520","Z961"],"date":["2025-03-14","2023-07-17","2023-07-17","2024-08-26","2025-06-17","2023-01-11","2023-01-11","2023-01-11","2023-01-11","2024-03-27","2023-07-17","2023-11-15","2023-01-06","2024-01-04","2023-01-11","2024-03-02","2024-03-02","2023-11-15","2025-03-18","2024-07-09","2024-12-16","2024-12-16","2025-10-08","2025-01-13","2023-01-06","2024-12-16","2024-12-16","2023-09-07","2025-07-10","2025-10-22","2025-03-18","2024-07-23","2025-07-10","2025-06-24","2022-10-11","2022-10-19","2022-05-12","2022-05-12","2022-05-12","2022-03-29"],"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":[["","","BUPROPION XL","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","BUPROPION HCL SR","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}