{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara A Purington","gend":1,"currentgend":"","add":"1638 LEWISTON RD","city":"LITCHFIELD","state":"ME","zip":"04350","dob":"1951-02-23","age":"","mstatus":"","insh":"10000047815","cliId":"","pno":2077379997,"cno":"","email":"","ename":"","eno":"","pphy":"MCDONALD, JULIA","ppno":2076261561,"pcpadd":"Maine Dartmouth Family Medicine,149 North St Dept Family Med","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"MAINE DARTMOUTH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2072684618,"add2":"","add3":"","madd1":"1638 LEWISTON RD","madd2":"","madd3":"","mcity":"LITCHFIELD","mstate":"ME","mzip":"04350","pcpfaxno":2076261902,"pcpnpi":1477849073,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4CX0HG5CX45","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z87891","S46011A","I088","I129","I739","Z1211","D120","K5730","K640","N1831","M19011","Z955","Z1231","N1830","S46011D","R079","S39012A","X58XXXA","Y9389","K551","R109","S43004A","W19XXXA","I10","M25511","M25561","W010XXA","S30861A","R042","S70361A","W57XXXA","I249","I25810","I214","I70201","I701","N2889","R1084","I25110","Z122","I2510","I70211","T82856A","Z95828","M2170","M7601","Z96641","K5900","M8589","Z780","R519","R844","R4182","Z5321","H9202","H938X2","N1832","M75120","F17200","E785","M25461","Z0001","R1011","Z0000","M75121","Z01818","Z720","I70213","R944","K559","J441","S82121A","Z01810","F17210","Z8616","Z951","I25700","R0789","I6523","M2011","M79672","M79671","M7732","M2012","J320","R0600","G479","R531","S20469A","D122"],"date":["2025-07-01","2024-01-23","2025-10-19","2025-08-19","2025-04-24","2024-06-11","2024-06-11","2024-06-11","2024-06-11","2024-11-06","2024-01-23","2024-01-17","2025-06-30","2025-10-24","2024-08-07","2025-10-22","2024-06-28","2024-06-28","2024-06-28","2025-04-24","2024-09-27","2024-01-23","2024-01-23","2024-08-15","2023-11-30","2023-11-30","2023-11-20","2025-05-30","2025-10-14","2025-05-30","2025-05-30","2025-10-15","2025-10-16","2025-10-26","2024-08-15","2024-11-06","2024-08-15","2024-08-15","2025-10-19","2025-07-01","2025-10-30","2025-10-22","2025-04-24","2025-04-24","2023-02-06","2024-08-07","2024-08-07","2024-09-27","2024-06-24","2024-06-24","2023-10-17","2023-10-17","2025-10-16","2025-10-13","2023-08-02","2023-08-02","2025-11-11","2024-01-23","2024-01-23","2024-01-23","2023-11-20","2024-05-06","2024-06-28","2025-05-12","2024-01-23","2025-10-17","2025-10-24","2023-04-17","2023-04-17","2024-09-24","2024-11-29","2024-01-03","2025-10-19","2025-10-20","2024-11-29","2024-11-29","2025-11-03","2025-10-14","2025-10-17","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-10-25","2022-11-07","2022-11-07","2022-11-07","2022-11-07","2022-10-02","2022-09-08"],"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":[["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","TRAMADOL HCL","","","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":""}]}]}