{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Rhonda A Holcomb","gend":1,"currentgend":"","add":"998 ROOSEVELT TRL","city":"NAPLES","state":"ME","zip":"04055","dob":"1950-07-01","age":"","mstatus":"","insh":"10000057731","cliId":"","pno":2076933234,"cno":2072090922,"email":"Rhonda2@roadrunner.com","ename":"","eno":"","pphy":"SAUCIER, NICOLE M","ppno":2076936106,"pcpadd":"Naples Family Practice,410 Roosevelt Trl","pcpcity":"Naples","pcpstate":"ME","pcpzip":"04055","pcpcounty":"","pcpid":"","pcpname":"NAPLES FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 54","madd2":"","madd3":"","mcity":"NAPLES","mstate":"ME","mzip":"04055","pcpfaxno":2076934026,"pcpnpi":1467094656,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7T36PY3PE55","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1712","Z96652","Z471","G8918","M9903","S335XXA","M5441","M9907","Z0000","R7303","M9901","M9902","M9904","G40109","R52","Z1231","Z01818","E559","G8928","Z0101","H353131","M25562","R6889","E669","Z86010","M25511","M5450","K649","M25569","M79646"],"date":["2025-05-27","2025-09-05","2025-09-05","2025-05-27","2023-09-22","2023-06-02","2023-06-02","2023-06-02","2025-08-13","2024-05-03","2023-09-22","2023-09-22","2023-09-22","2025-10-21","2025-08-28","2025-10-22","2025-05-12","2025-10-21","2025-05-27","2025-02-04","2025-02-04","2025-07-10","2023-09-29","2023-11-07","2022-12-01","2023-01-10","2022-12-07","2022-12-01","2025-03-03","2022-10-14"],"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",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","DIVALPROEX SODIUM ER","","","Select","Select",""],["","","CEFADROXIL","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","GAVILYTE-C","","","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":""}]}]}