{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara Tanguay","gend":1,"currentgend":"","add":"8 DUSTY LN","city":"LIMINGTON","state":"ME","zip":"04049","dob":"1950-09-20","age":"","mstatus":"","insh":"10000043926","cliId":"","pno":2073299181,"cno":"","email":"barbtanguay@gmail.com","ename":"","eno":"","pphy":"ACHILLE, JUSTINE","ppno":2078392559,"pcpadd":"Martins Point Health Care,PO Box 9746","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04104","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"8 DUSTY LN","madd2":"","madd3":"","mcity":"LIMINGTON","mstate":"ME","mzip":"04049","pcpfaxno":2075231135,"pcpnpi":1962962324,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2EN8TH4JV25","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M722","M24572","M24571","M7731","E782","Z1231","Z23","M79671","M8589","Z780","N179","Z91018","Z91010","Z13220","Z136","M25532","M76821","M25531","M19079","R079","K219","E785","R002","N1831","M79675","M19072","M7732","S92325A","M79672","L403","L814","Z85828","L578"],"date":["2023-12-14","2023-12-14","2023-12-14","2023-12-14","2025-10-17","2024-11-07","2025-10-23","2023-10-20","2023-08-21","2023-08-21","2024-11-07","2024-11-07","2024-11-07","2023-10-04","2023-10-04","2023-10-09","2023-09-19","2023-10-09","2023-10-08","2023-11-01","2023-10-18","2024-10-15","2022-10-19","2022-10-13","2022-08-12","2022-08-12","2022-08-12","2022-08-25","2022-08-25","2022-08-11","2022-08-11","2022-08-11","2022-08-11"],"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":[["","","SERTRALINE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","BETAMETHASONE DIPROP AUGMENTED","","","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":""}]}]}