{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joanne I Lerette","gend":1,"currentgend":"","add":"2 SPEAR STREET","city":"LISBON FALLS","state":"ME","zip":"04252","dob":"1951-02-03","age":"","mstatus":"","insh":"10000045049","cliId":"","pno":2075765371,"cno":"","email":"joannelerette@gmail.com","ename":"","eno":"","pphy":"POWERS, RENEE M","ppno":"","pcpadd":"329 MAINE ST STE A200,","pcpcity":"BRUNSWICK","pcpstate":"ME","pcpzip":"40113310","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2 SPEAR STREET","madd2":"","madd3":"","mcity":"LISBON FALLS","mstate":"ME","mzip":"04252","pcpfaxno":2076185688,"pcpnpi":1033545629,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8QA1X41TV95","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":["Z0000","E119","J449","R42","N200","N2889","H5789","R300","N3000","R7303","E785","R809","I10","Z1159","F418","Z1231","R911","R8290","N3941","K760","I252","Z87891","F411","R9389","M47814","R918","I2510","I517","H04123","E041","Z01818","R55","M549","E079","R519","J322","G238","I6782","M47812","M4802","J984","N132","D7389","K5730","R6889","Z23"],"date":["2025-07-11","2025-08-11","2025-11-11","2025-07-11","2025-11-11","2025-11-03","2023-11-20","2025-08-15","2025-09-05","2025-01-21","2023-10-06","2023-10-06","2025-11-11","2023-10-06","2025-11-11","2023-06-26","2025-10-16","2025-09-05","2025-09-05","2025-11-11","2025-11-11","2025-11-11","2025-10-03","2025-09-29","2024-07-19","2025-09-29","2025-09-29","2025-09-29","2024-08-06","2025-03-10","2025-11-11","2025-02-05","2024-07-19","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-02-03","2025-07-26","2025-10-09","2025-10-09","2025-10-09","2022-11-13","2022-10-10"],"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",""],["","","MELOXICAM","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","CHOLESTYRAMINE LIGHT","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","GLIMEPIRIDE","","","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":""}]}]}