{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rhona A Vosmus","gend":1,"currentgend":"","add":"299 N GORHAM ROAD","city":"GORHAM","state":"ME","zip":"04038","dob":"1951-03-09","age":"","mstatus":"","insh":"10000047975","cliId":"","pno":2073108531,"cno":"","email":"rhonav51@gmail.com","ename":"","eno":"","pphy":"KATZ, JAMES A","ppno":2077711717,"pcpadd":"144 STATE ST,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41013776","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"299 N GORHAM ROAD","madd2":"","madd3":"","mcity":"GORHAM","mstate":"ME","mzip":"04038","pcpfaxno":2077711727,"pcpnpi":1588605604,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9MJ2U06XY85","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1711","S0990XA","Z96651","Z471","S199XXA","Z0000","Z1239","Z780","Z23","Z1231","Z01812","M25561","S2020XA","R911","V4950XA","D649","I10","Z7982","B351","I7389","L84","E6601","Z6842","G8918","I129","N189","Z13820","M542","B353","D75839","R079","D3131","Z0101","Z6843","E785","M2141","M2142","M79671","M79672","S3991XA","S3993XA","Z0001","Z7182","Z713","R339","S299XXA","R7989","R5383","C4359"],"date":["2025-02-14","2025-05-20","2025-10-17","2025-10-17","2025-05-20","2023-10-06","2023-10-06","2024-01-24","2024-04-19","2024-12-03","2024-09-23","2024-12-23","2025-05-29","2025-05-29","2025-05-29","2025-02-14","2025-02-14","2025-02-14","2024-03-26","2024-03-26","2024-03-26","2024-10-03","2024-10-03","2024-10-03","2024-10-03","2024-10-03","2024-01-24","2025-05-20","2023-09-12","2023-10-13","2025-05-20","2025-06-27","2025-06-27","2024-04-29","2024-04-19","2023-11-14","2023-11-14","2023-11-14","2023-11-14","2025-05-20","2025-05-20","2024-12-10","2024-12-10","2024-12-10","2024-10-22","2025-05-20","2024-02-13","2024-02-13","2022-08-04"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","BUPROPION HCL","","","Select","Select",""],["","","BUPROPION XL","","","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":""}]}]}