{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Randi E Austin","gend":1,"currentgend":"","add":"25 BELFIELD RD","city":"CAPE ELIZABETH","state":"ME","zip":"04107","dob":"1950-02-04","age":"","mstatus":"","insh":"10000051224","cliId":"","pno":2077995614,"cno":2072334736,"email":"juneaustin@gmail.com","ename":"","eno":"","pphy":"SUBAK KRAH, SARAH","ppno":2077745816,"pcpadd":"100 FODEN ROAD WEST,SUITE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"25 BELFIELD RD","madd2":"","madd3":"","mcity":"CAPE ELIZABETH","mstate":"ME","mzip":"04107","pcpfaxno":2078741483,"pcpnpi":1780643437,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5H93UX3YN90","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F411","F331","M546","C50411","Z170","M810","E039","E559","R5383","C50911","Z08","Z0001","R310","F32A","F341","H43813","H04123","H18513","N3001","R922","R3129","N3091","Z87891","N898","Z853","F4321","Z131","N3289","E785","Z0000","D494","Z0101","L814","L821","L853","L578","M8589","C50919","M25561","Z98890","Z79811","M1711","M23321","R309","R6889","R399","R300","M8580","L820","H35372","H524","F419","M5124","Z23","S83231A","R92321","R928","M2550","M549","N281","R350","H5051","M7742","M2012","M2042","Z01419","Z8041","H903","Z923","L299","L219","R030","G5762","R059"],"date":["2025-10-24","2025-10-06","2024-07-12","2025-07-23","2025-07-23","2024-06-12","2025-09-25","2025-03-25","2025-03-25","2024-05-28","2025-09-23","2025-03-25","2025-05-28","2025-05-28","2025-10-06","2024-01-19","2024-04-25","2025-02-03","2025-07-26","2023-05-24","2025-04-21","2025-05-28","2025-09-23","2023-08-09","2025-09-23","2025-09-03","2024-03-28","2025-06-05","2025-03-18","2024-03-20","2025-06-24","2023-03-01","2024-03-22","2023-03-06","2023-03-06","2024-03-22","2024-09-03","2024-09-03","2025-09-09","2024-05-28","2025-09-23","2025-09-24","2025-09-24","2023-08-03","2023-12-30","2025-07-26","2023-09-23","2025-03-25","2025-05-23","2025-02-03","2025-02-03","2024-11-12","2024-07-12","2022-12-20","2025-10-08","2025-07-28","2025-07-28","2023-01-24","2025-09-09","2025-03-03","2025-09-27","2024-04-25","2022-06-20","2022-06-20","2022-06-20","2022-06-14","2022-06-14","2022-04-14","2021-11-18","2022-02-14","2022-02-14","2022-02-22","2022-02-22","2022-02-22"],"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":[["","","ALPRAZOLAM","","","Select","Select",""],["","","SYNTHROID","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","CLONAZEPAM","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","EXEMESTANE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","ANASTROZOLE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","CLOTRIMAZOLE","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}