{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joanna L Parker","gend":1,"currentgend":"","add":"2 DUSTIN DR","city":"LIMINGTON","state":"ME","zip":"04049","dob":"1971-09-12","age":"","mstatus":"","insh":"10000046004","cliId":"","pno":2078380026,"cno":"","email":"tonto_spirit@yahoo.com","ename":"","eno":"","pphy":"JOHNSON, JESSICA","ppno":2078392559,"pcpadd":"Martins Point Health Care,575 Main St","pcpcity":"Gorham","pcpstate":"ME","pcpzip":"04038","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"2 DUSTIN DR","madd2":"","madd3":"","mcity":"LIMINGTON","mstate":"ME","mzip":"04049","pcpfaxno":"","pcpnpi":1477001501,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3GQ9EE5FT15","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":["M5450","E669","R5383","S79911A","F329","M25512","M25519","Z1231","M5416","F418","N6032","N610","F4310","T8544XA","K219","F419","R748","M7711","R002","Z87891","Z23","F4312","M5136","E538","K047","I441","Z9882","N3941","R351","N3281","F331","Z45812","N951","J3489","R221","F17210","R030","Z803","Z79890","F520","R220","L501","Z91018","Z1389","K0889","L570","M25531","M778","G8929","H524","Z0101","H52223","R12","T782XXD","Z1279","M51369","L820","R140","M51379","M2548","M47816","R6889","Z79891","R1310","L989"],"date":["2025-06-11","2025-08-28","2024-10-29","2024-08-23","2025-07-10","2025-05-21","2025-05-21","2024-12-02","2025-01-31","2025-05-22","2024-05-15","2024-05-15","2025-04-17","2024-05-15","2024-05-15","2024-05-15","2025-09-19","2024-04-09","2024-08-27","2024-08-23","2023-11-29","2025-09-25","2024-05-07","2025-06-06","2023-11-12","2023-01-09","2023-12-21","2023-01-13","2023-01-13","2023-01-13","2025-10-30","2024-05-15","2025-08-06","2024-05-05","2023-11-12","2023-09-01","2023-05-18","2023-09-01","2025-08-06","2025-08-06","2023-11-12","2024-03-22","2024-03-22","2022-12-09","2023-11-12","2024-10-01","2024-02-26","2024-02-26","2024-02-26","2025-03-07","2025-03-07","2025-03-07","2024-03-22","2024-03-22","2022-12-09","2025-02-11","2025-10-07","2025-09-19","2025-02-11","2025-02-11","2025-02-11","2023-12-20","2022-10-27","2022-09-30","2022-09-30"],"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":[["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","ESTRADIOL (TWICE WEEKLY)","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","LYLLANA","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","MINIVELLE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","LUBIPROSTONE","","","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":""}]}]}