{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Susan J Bryant","gend":1,"currentgend":"","add":"174 CENTER BRIDGE RD","city":"TURNER","state":"ME","zip":"04282","dob":"1953-02-03","age":"","mstatus":"","insh":"10000057607","cliId":"","pno":2072253147,"cno":"","email":"marshallandsue@hotmail.com","ename":"","eno":"","pphy":"HUNTRESS, LAURIE A","ppno":2075243501,"pcpadd":"180 CHURCH HILL RD,STE 1","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"174 CENTER BRIDGE RD","madd2":"","madd3":"","mcity":"TURNER","mstate":"ME","mzip":"04282","pcpfaxno":2075242459,"pcpnpi":1629046693,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2G34AJ0KJ79","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L820","L298","L538","L570","X32XXXA","L738","L814","D225","D2262","R0600","I4891","I10","I63512","E119","I080","R002","E782","R946","G459","I340","H401131","H353131","I639","R0609","Z1231","R4182","R4789","L821","E785","E559","R059","R079","Z0000","R0602","Z9189","Z8673","R42","R61","R110","R9431","R109","I6602","I499","I361","Z09","E8352","Z0101","Z1211","K5730","K640","Z86010","M5489","Z23","R5381","E113293","G458","I6609","H2513","R208","R4781","I6523","R4701","R6889"],"date":["2024-02-15","2024-02-15","2024-02-15","2023-02-09","2023-02-09","2025-02-19","2025-02-19","2023-02-09","2023-02-09","2025-05-28","2025-11-04","2025-10-16","2025-07-14","2025-09-11","2025-07-15","2025-05-12","2024-11-21","2024-12-10","2025-10-11","2025-10-28","2025-05-13","2025-05-13","2025-07-17","2025-04-15","2025-06-14","2025-07-15","2025-07-17","2025-02-19","2025-07-17","2025-02-25","2025-07-14","2025-03-11","2025-04-08","2025-10-16","2025-10-14","2025-10-11","2023-08-25","2023-08-25","2023-08-25","2023-08-25","2023-11-14","2025-07-14","2025-11-04","2025-10-28","2025-10-24","2024-12-10","2025-05-13","2023-06-14","2023-06-14","2023-06-14","2023-06-14","2023-01-05","2024-11-21","2023-08-25","2025-07-31","2025-07-15","2025-07-15","2024-11-01","2024-02-15","2025-07-28","2025-07-14","2025-07-14","2022-10-27"],"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":[["","","XARELTO","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","BENAZEPRIL HCL","","","Select","Select",""],["","","VERAPAMIL ER","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","BRIMONIDINE TARTRATE","","","Select","Select",""],["","","FREESTYLE TEST STRIPS","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","LUMIGAN","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","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":""}]}]}