{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara J Sawyer","gend":1,"currentgend":"","add":"4 SCHOOL ST","city":"Standish","state":"ME","zip":"04084","dob":"1950-05-15","age":"","mstatus":"","insh":"10000041078","cliId":"","pno":2076422205,"cno":"","email":"DVSAW100S@NETSCAPE.NET","ename":"","eno":"","pphy":"STOCKWELL, GEORGE W","ppno":2078930290,"pcpadd":"144 STATE ST,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41013776","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4 SCHOOL ST","madd2":"","madd3":"","mcity":"Standish","mstate":"ME","mzip":"04084","pcpfaxno":2078930295,"pcpnpi":1548293772,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9R82Q35RM26","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z1231","K5010","R2689","M79652","S76312A","K5900","G8929","M546","M722","M19041","M19072","M67874","Z961","H16223","M109","H0288A","H0288B","H0100A","H04123","M79644","M7989","M79641","M85841","J40","M65321","R059","H6591","H6981","S39012A","C4371","S29012A","Z7952","K5090","H6121","Z01419","R21","R490","Z96612","R053","Z8614","Z0001","H0259","Z79899","M1990","L570","Z85820","L821","D225","D492","H0100B","H04203","M25552","H903","L578","Z8349","D7589","R5383","Z0101","E785","K219","E039","M549","W1830XA","R6889","R0982","Z0000","H9311","M5450","Z1211","M19071","B351","G6289","Z0389","K5730","K648","M25512","B029","Z8616","M818","T380X5A","M159","Z96652","M1711","S838X2A","Z96651","R109","Z1159","H04121","M19011","M19012"],"date":["2025-08-25","2025-10-15","2025-11-17","2023-03-22","2023-03-22","2023-07-27","2023-07-27","2025-03-13","2024-01-26","2025-02-21","2025-08-01","2025-08-01","2023-11-29","2024-12-11","2025-02-21","2024-12-11","2024-12-11","2024-12-11","2024-04-22","2025-02-28","2025-02-19","2025-02-19","2025-02-19","2025-11-06","2025-02-28","2025-04-07","2025-07-23","2025-07-23","2023-09-24","2025-01-30","2023-09-24","2023-09-24","2023-09-24","2024-11-10","2023-12-01","2024-01-04","2024-08-01","2023-09-24","2024-11-25","2025-02-28","2025-09-11","2023-05-11","2024-06-25","2025-07-16","2025-07-24","2025-07-24","2025-07-24","2025-07-24","2024-06-11","2024-05-09","2024-05-30","2025-09-01","2023-11-20","2023-03-15","2024-07-10","2024-01-16","2024-06-24","2025-02-10","2024-07-21","2024-07-21","2024-07-21","2025-08-26","2025-08-26","2023-11-29","2025-07-23","2024-07-30","2023-05-24","2025-09-01","2024-03-19","2023-10-19","2023-10-19","2023-10-19","2025-08-25","2024-03-19","2024-03-19","2022-12-18","2024-01-04","2023-01-13","2022-11-22","2022-11-16","2022-10-13","2022-10-05","2022-10-20","2022-10-05","2022-10-20","2022-09-27","2022-09-20","2022-09-15","2022-08-15","2022-08-15"],"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":[["","","GEMFIBROZIL","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","SULFASALAZINE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","SULFASALAZINE DR","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","TYRVAYA","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","RESTASIS","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","LOTEMAX","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","LOTEPREDNOL ETABONATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","CIPROFLOXACIN-DEXAMETHASONE","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","FORTEO","","","Select","Select",""],["","","UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","MESALAMINE","","","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":""}]}]}