{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"April Sesin","gend":1,"currentgend":"","add":"16 POWELL AVE UNIT 8","city":"Oakland","state":"ME","zip":"04963","dob":"1963-04-19","age":"","mstatus":"","insh":"10000053387","cliId":"","pno":2076083870,"cno":2073412733,"email":"aprilsjubilee@yahoo.com","ename":"","eno":"","pphy":"REATIRAZA, JOCELIN N","ppno":2074652181,"pcpadd":"Oakland Family Medicine,25 First Park Dr","pcpcity":"Oakland","pcpstate":"ME","pcpzip":"04963","pcpcounty":"","pcpid":"","pcpname":"OAKLAND FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 POWELL AVE UNIT 8","madd2":"","madd3":"","mcity":"Oakland","mstate":"ME","mzip":"04963","pcpfaxno":2076218801,"pcpnpi":1598777930,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4GT6ND2CU30","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M65821","R6889","Z96621","B351","Z01818","M069","M25521","M25522","M19029","L97529","Z8739","M0579","M3501","Z79899","Z1231","Z1211","M25421","M79672","Z79622","L820","R208","L538","R195","M65121","Z1212","Z13820","M059","M19021","L718","L578","D225","L814","M8588","M85859","Z780","M05821","L821","L573","H5213","H52223","H524","M8589","L84","H16042","M6588","Z5333","M06822","Z4789","H401131","M19022","M25822"],"date":["2023-12-04","2023-01-01","2023-12-04","2024-05-07","2023-11-09","2025-08-27","2025-01-02","2024-10-16","2024-10-16","2024-11-07","2024-11-07","2025-09-05","2025-05-22","2025-05-22","2025-05-07","2023-04-11","2024-12-20","2024-10-29","2024-10-29","2025-11-06","2025-11-06","2025-11-06","2025-08-26","2023-12-04","2023-11-01","2025-09-25","2023-08-28","2024-12-20","2024-10-31","2024-10-31","2024-10-31","2024-10-31","2025-09-25","2025-09-25","2025-09-25","2025-08-27","2023-06-05","2023-06-05","2024-09-12","2024-09-12","2024-09-12","2023-08-28","2023-06-05","2022-11-22","2022-10-26","2022-10-26","2022-10-26","2022-11-09","2022-10-12","2022-09-15","2022-09-15"],"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":[["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","XELJANZ XR","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","XELJANZ","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","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":""}]}]}