{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cynthia B Abbott","gend":1,"currentgend":"","add":"469 HIGHLAND RD","city":"BRIDGTON","state":"ME","zip":"04009","dob":"1947-03-06","age":"","mstatus":"","insh":"10000045179","cliId":"","pno":2076472352,"cno":"","email":"Declined@031125.com","ename":"","eno":"","pphy":"BERGERON POULIN, CHARLES KEVIN","ppno":2076936106,"pcpadd":"76 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407649","pcpcounty":"","pcpid":"","pcpname":"NAPLES FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"469 HIGHLAND RD","madd2":"","madd3":"","mcity":"BRIDGTON","mstate":"ME","mzip":"04009","pcpfaxno":2076934026,"pcpnpi":1992291249,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1R80GU7CJ44","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R509","S2220XA","R079","M25562","M069","S2220XD","I4510","R5383","K2270","M0609","J449","D472","R040","I10","I4819","I4891","R0902","Z79899","N179","J849","F329","E876","I959","I340","J189","D84821","D638","Z760","R491","D649","R490","J3801","A419","R109","R0602","M797","D61818","R059","G9341","M67432","R5381","I358","Z23","F419","I499","E8720","Z95811","Z7901","H26493","K625","R69","M19071","M2011","M2041","F411","L304","R918","R000","R0600","D539","I452","M609","J929","M2550","R1110","S8992XA","R0781","I081","R4182","R531","Z452","J90","T451X1A","R0609","H26492","H35443","M79671","M79672","I129","N189","J9601","M5136","Z139","Z136","J069","R498","J3489","Z5181","Z719","J439","M19032","J9809","Z780","J432","J939","R9389","Z09","I5030","E785","Z1231","K529"],"date":["2025-08-24","2024-10-08","2025-08-24","2025-07-11","2025-10-23","2024-11-22","2025-05-22","2022-12-05","2023-07-07","2025-10-20","2025-07-25","2023-08-22","2025-05-25","2024-11-19","2025-07-23","2025-08-24","2025-05-01","2025-10-16","2022-12-09","2025-10-16","2025-09-10","2022-12-08","2022-12-08","2024-11-08","2023-01-04","2022-12-14","2023-06-20","2023-08-15","2023-07-25","2025-07-31","2023-07-07","2023-09-07","2022-12-23","2024-06-14","2025-08-22","2025-10-16","2022-12-12","2024-10-04","2022-12-15","2024-07-02","2024-10-11","2025-05-22","2025-02-07","2024-09-09","2025-08-14","2025-08-22","2025-05-22","2025-05-22","2024-11-13","2025-08-06","2023-07-13","2024-02-06","2024-02-06","2024-02-06","2024-03-19","2024-11-06","2023-10-16","2023-10-16","2025-08-24","2025-08-18","2025-03-12","2023-06-06","2023-08-03","2025-10-07","2025-08-22","2025-07-11","2024-10-08","2024-12-03","2025-08-23","2022-12-07","2022-12-08","2024-07-18","2025-08-26","2025-08-26","2024-09-12","2024-09-12","2023-09-21","2023-09-21","2025-05-01","2025-05-01","2025-05-01","2024-03-18","2024-01-11","2023-01-31","2023-10-19","2023-09-07","2023-09-07","2025-02-21","2024-10-03","2024-07-18","2024-04-17","2025-02-11","2024-03-18","2024-07-18","2023-04-14","2023-08-03","2024-10-22","2024-11-19","2024-11-19","2024-03-18","2022-10-20"],"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":[["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","JOURNAVX","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","DOFETILIDE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","ORENCIA CLICKJECT","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","LEFLUNOMIDE","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ENBREL SURECLICK","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ADVAIR HFA","","","Select","Select",""],["","","ACYCLOVIR","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}