{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carole E Turner","gend":1,"currentgend":"","add":"39 MOORES MILLS RD","city":"CANAAN","state":"ME","zip":"04924","dob":"1943-12-20","age":"","mstatus":"","insh":"10000052110","cliId":"","pno":2075098131,"cno":"","email":"certurner@yahoo.com","ename":"","eno":"","pphy":"BLANCHETTE, CHRISTOPHER D","ppno":2078584844,"pcpadd":"\tSomerset Primary Care,62 Main St","pcpcity":"Skowhegan","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"SOMERSET PRIMARY CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"39 MOORES MILLS RD","madd2":"","madd3":"","mcity":"CANAAN","mstate":"ME","mzip":"04924","pcpfaxno":2078580348,"pcpnpi":1023244670,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3JX5RA1DY75","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K921","N1330","R519","R310","R0789","M9901","M5382","G44209","M9902","E611","D649","I214","K922","E1165","K219","Z0000","D509","E785","R319","E039","Z87440","R0609","R8289","M5116","K449","M5450","M8580","M47816","I2510","I2089","Z79899","M7989","M4726","M48061","H6123","I10","E119","M5431","R2231","Z01812","K760"],"date":["2025-09-02","2025-05-09","2025-05-20","2025-06-10","2025-06-23","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-03-12","2025-05-08","2025-07-30","2025-05-12","2025-05-07","2025-02-19","2025-03-17","2025-01-02","2025-07-07","2025-06-26","2025-05-06","2025-06-02","2025-02-06","2025-06-10","2025-10-08","2025-08-04","2025-11-10","2025-11-10","2025-11-10","2025-08-06","2025-07-28","2025-09-16","2025-10-15","2025-08-15","2025-08-15","2025-08-20","2025-11-13","2025-09-03","2025-07-09","2025-10-09","2022-07-07","2022-06-24"],"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":[["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","ARMOUR THYROID","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ONETOUCH ULTRA2","","","Select","Select",""],["","","INSULIN GLARGINE SOLOSTAR","","","Select","Select",""],["","","ACCU-CHEK GUIDE MONITOR SYSTEM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","NP THYROID","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}