{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rhonda L Clement","gend":1,"currentgend":"","add":"409 CASTINE RD","city":"ORLAND","state":"ME","zip":"04472","dob":"1954-11-09","age":"","mstatus":"","insh":"10000055174","cliId":"","pno":2074792244,"cno":"","email":"rhonjay@gmail.com","ename":"","eno":"","pphy":"CLIFFORD, TIMOTHY S","ppno":2074697371,"pcpadd":"110 BROADWAY,","pcpcity":"BUCKSPORT","pcpstate":"ME","pcpzip":"44164612","pcpcounty":"","pcpid":"","pcpname":"BUCKSPORT REGIONAL HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"409 CASTINE RD","madd2":"","madd3":"","mcity":"ORLAND","mstate":"ME","mzip":"04472","pcpfaxno":2074697306,"pcpnpi":1033154281,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4C81UG2VG01","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L4050","L409","M1990","R945","R059","M461","R079","R1011","R110","Z87891","Z79899","Z1231","M65332","U071","E1169","E785","K8010","I2510","S83231A","S63592A","X58XXXA","Z1212","Z1211","M160","M65342","M65352","M65842","M19071","M19072","Z0101","R051","K8020","M7918","I255","E7800","Z955","M25561","M720","J209","M5416","I10","M7071","Z7961","E049","E119","I214","G5622","M7702","I77819","J189","Z01818","R946","Z0000","K8050","M19032","G5623","J449","R002","J029","M6588","M23321","M23300","M79642","M5450","M6580","Z98890","K760","M5117","M4727","M4317"],"date":["2025-07-08","2024-10-03","2023-03-22","2023-03-22","2024-01-26","2025-04-10","2024-02-02","2023-01-05","2023-01-05","2025-07-08","2025-01-08","2025-04-23","2024-09-05","2023-02-24","2024-12-05","2024-12-05","2023-01-05","2025-02-03","2025-07-14","2023-12-13","2023-12-13","2024-01-02","2024-01-02","2025-04-10","2024-09-05","2024-09-05","2024-07-10","2022-12-05","2022-12-05","2024-11-19","2025-02-20","2022-11-01","2024-04-03","2024-07-03","2024-08-22","2024-07-03","2025-05-27","2024-09-05","2025-03-06","2023-09-05","2024-05-13","2024-12-26","2025-07-08","2024-12-05","2024-05-13","2024-02-06","2023-11-27","2023-11-27","2025-03-14","2025-02-20","2023-11-10","2023-08-25","2023-05-26","2023-01-05","2023-11-01","2023-11-01","2025-03-21","2025-02-03","2025-02-12","2025-06-13","2025-07-14","2025-07-14","2024-03-20","2022-10-05","2024-07-10","2023-09-21","2022-11-01","2022-08-31","2022-08-31","2022-08-31"],"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":[["","","JARDIANCE","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","RYBELSUS","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","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":{"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":{"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":""}]}]}