{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sharon J Tilton","gend":1,"currentgend":"","add":"237 GOODHUE RD","city":"Sidney","state":"ME","zip":"04330","dob":"1951-04-10","age":"","mstatus":"","insh":"10000048463","cliId":"","pno":2075473525,"cno":"","email":"artistree8@roadrunner.com","ename":"","eno":"","pphy":"BOLDUC, KATELYN","ppno":"","pcpadd":"81 MEDICAL CENTER DR STE 2200,","pcpcity":"BRUNSWICK","pcpstate":"ME","pcpzip":"40112765","pcpcounty":"","pcpid":"","pcpname":"OAKLAND FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2074464741,"add2":"","add3":"","madd1":"237 GOODHUE RD","madd2":"","madd3":"","mcity":"Sidney","mstate":"ME","mzip":"04330","pcpfaxno":2076185670,"pcpnpi":1548647225,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3UC7M35TM79","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H353132","Z98890","Z0000","I10","D225","Z1231","Z01818","H527","H2511","H43813","Z136","R109","R1110","Z9049","H3530","S32010A","S32018A","E785","E559","R197","M85859","R112","Z1211","D122","D123","K5730","N390","X58XXXA","M542","S0990XA","R102","S299XXA","M85851","M85852","Z780","K625","Z0001","H6122","Z23","H938X1","M8088XA","Z86010","K621","K635"],"date":["2025-07-07","2024-09-06","2025-06-17","2024-02-26","2024-02-26","2025-02-13","2025-11-04","2024-09-06","2023-09-08","2023-09-08","2024-02-22","2025-09-20","2025-09-20","2025-09-20","2025-06-17","2025-10-10","2025-10-13","2025-02-24","2025-10-08","2025-03-13","2025-09-30","2025-09-22","2024-05-17","2024-05-17","2024-05-17","2024-05-17","2025-09-22","2025-09-22","2025-09-20","2025-09-20","2025-09-20","2025-09-20","2025-09-30","2025-09-30","2025-09-30","2025-03-11","2023-01-31","2023-01-31","2023-01-31","2023-01-31","2025-10-13","2022-10-11","2022-10-11","2022-10-11"],"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":[["","","ONDANSETRON ODT","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","CALCITONIN-SALMON","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}