{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Elsie J Hillman","gend":1,"currentgend":"","add":"461 MUTTON LANE RD","city":"CLINTON","state":"ME","zip":"04927","dob":"1948-04-04","age":"","mstatus":"","insh":"10000052880","cliId":"","pno":2074268408,"cno":"","email":"elsiehillman2018@gmail.com","ename":"","eno":"","pphy":"PRESTON, DAVID G","ppno":2078731098,"pcpadd":"Mid Maine Medicine,325B Kennedy Memorial Dr","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"THAYER INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 494","madd2":"","madd3":"","mcity":"CLINTON","mstate":"ME","mzip":"04927","pcpfaxno":2078735461,"pcpnpi":1871559203,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5WX3JU0EU82","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L02213","T8141XA","R0602","I2510","L929","S299XXA","I7143","B0239","I509","I442","R112","K8590","M4854XA","Z7901","S22069A","R600","W19XXXA","Y831","Z950","Z1231","D6869","M8008XD","M4856XA","M25552","M79605","Y92009","R531","Z45018","R1011","H52223","H353131","M19011","T8189XA","S21109A","I081","Z4502","Z0000","E039","Z23","M8588","M5450","K828","I4891","I209","I5040","T827XXA","Z952","T8189XD","J301","R590","I952","R079","S42101A","K921","M8088XA","S32059A","R000","Z743","S32019A","K7460","R140","I700","Z4801","K5900","X500XXA","Y93E9","A419","K920","D62","K259","R109","K922","I110","M47814","S7011XD","I5032","R630","Z681","S7011XA","M810","I5042","I480","R197","I771","S21101A","L089","R188","R1010","H43813","H2010","H5211","E876","R42","R55","S3210XA","T8469XD","S8002XA","R0600","Z789","Z20822","M5431","Z0001","I071","Z959","B999","D696","S32020A","M4857XA","M7989","L905","I440","B029","S22059A","X58XXXA","M488X4","R5381","R2689","R7989","R195","Z951","W19XXXD","K8510","M47816","R4182"],"date":["2025-09-11","2025-06-23","2024-12-13","2025-03-30","2025-07-17","2025-04-03","2025-05-28","2024-07-29","2025-02-05","2025-06-13","2023-11-19","2024-11-19","2025-05-21","2025-06-04","2025-05-21","2025-06-05","2025-06-05","2025-01-18","2025-09-16","2023-04-26","2024-08-20","2024-01-25","2023-12-22","2025-04-03","2025-04-03","2025-04-03","2024-03-26","2025-02-20","2024-12-13","2023-03-20","2023-03-20","2023-11-30","2025-02-22","2025-08-12","2025-06-12","2025-05-23","2024-05-30","2025-09-05","2024-05-30","2023-12-22","2023-12-22","2025-04-03","2025-06-04","2025-09-11","2025-06-13","2025-06-13","2025-06-13","2025-08-22","2023-04-18","2023-08-11","2023-04-18","2025-04-03","2025-03-30","2025-01-31","2023-12-05","2023-12-21","2025-05-28","2025-05-28","2023-12-21","2025-09-11","2025-01-30","2025-05-28","2025-01-20","2023-11-19","2023-10-02","2023-10-02","2024-10-27","2025-01-31","2025-01-31","2025-01-31","2025-05-28","2025-02-13","2024-08-20","2025-05-21","2024-09-03","2025-01-30","2023-08-11","2023-08-11","2024-08-15","2024-08-20","2024-11-05","2025-01-30","2025-06-20","2025-01-09","2025-01-21","2025-01-21","2024-10-27","2024-10-27","2023-03-20","2023-03-20","2023-03-20","2024-11-08","2024-04-02","2024-04-02","2023-12-26","2025-01-24","2025-04-04","2024-10-28","2025-04-03","2024-03-26","2023-09-12","2025-06-19","2025-01-17","2025-01-17","2025-01-18","2025-03-05","2023-11-17","2023-12-21","2024-12-30","2024-12-30","2024-05-29","2024-07-29","2025-05-21","2025-05-21","2023-11-17","2024-04-02","2024-02-27","2024-12-13","2025-01-30","2025-06-13","2024-09-03","2024-10-27","2023-10-02","2025-01-18"],"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":[["","","LINEZOLID","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","RANOLAZINE ER","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","CALCITONIN-SALMON","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":""}]}]}