{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rebecca A Elliott","gend":1,"currentgend":"","add":"21 HIGH ST","city":"MILLINOCKET","state":"ME","zip":"04462","dob":"1952-07-04","age":"","mstatus":"","insh":"10000055640","cliId":"","pno":2077234914,"cno":"","email":"beckie5821@gmail.com","ename":"","eno":"","pphy":"NIELSEN, LISA","ppno":2075282285,"pcpadd":"PO BOX 500,","pcpcity":"PATTEN","pcpstate":"ME","pcpzip":"47650500","pcpcounty":"","pcpid":"","pcpname":"KATAHDIN VALLEY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"21 HIGH ST","madd2":"","madd3":"","mcity":"MILLINOCKET","mstate":"ME","mzip":"04462","pcpfaxno":2075282880,"pcpnpi":1598706970,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9R58V67PN44","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R6889","D3132","N841","R928","Z1231","R921","I10","I081","I2699","Z780","Z23","Z1151","Z01419","N6022","I82402","E7800","Z0000","M25569","N888","Z01810","Z0101","Z87891","E119","Z124","N951","M170","E876","M25562","M1711","M1712","H47321","Z1211","G5602","E6601","I824Y2","R29818","R300","N390","G5600","I8290","Z86711","M25761","M25762","N8501","R600","Z09","R920","D242","N6489","I82412","I82452","I82812","K5730","N840","M25561","R3989","N889","Z860101","N959","Z86718"],"date":["2023-08-21","2024-01-17","2025-05-13","2024-01-09","2025-01-31","2024-01-09","2025-07-28","2023-09-25","2024-03-27","2024-05-17","2024-10-11","2023-10-31","2023-10-31","2022-11-04","2023-09-25","2023-09-25","2025-01-27","2023-01-19","2025-04-22","2025-09-15","2023-01-13","2025-05-13","2024-01-16","2023-10-31","2023-11-30","2025-08-28","2025-02-06","2024-02-21","2024-08-30","2024-02-21","2025-05-22","2025-02-12","2023-03-06","2024-01-04","2024-01-04","2024-01-04","2025-03-18","2025-03-18","2023-03-09","2024-02-07","2024-03-27","2024-02-21","2024-02-21","2024-03-06","2025-08-29","2025-01-29","2022-11-04","2022-11-04","2022-11-04","2023-09-25","2023-09-25","2023-09-25","2023-09-26","2024-03-06","2025-03-13","2023-10-31","2023-10-31","2025-01-29","2023-10-31","2023-10-31"],"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":[["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","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":""}]}]}