{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Carmel M Oshea","gend":1,"currentgend":"","add":"432 COTTAGE RD","city":"South Portland","state":"ME","zip":"04106","dob":"1950-10-16","age":"","mstatus":"","insh":"10000058780","cliId":"","pno":2076020800,"cno":"","email":"osheacarmel7@gmail.com","ename":"","eno":"","pphy":"CONNOLLY, MARY J","ppno":2078741489,"pcpadd":"100 FODEN RD WEST,SUITE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"432 COTTAGE RD","madd2":"","madd3":"","mcity":"South Portland","mstate":"ME","mzip":"04106","pcpfaxno":2078741483,"pcpnpi":1558535559,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4Q68VW3FA45","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1611","M25551","M6281","Z4789","M1612","M8588","I480","Z471","Z1231","H524","Z01818","Z7901","I10","I4891","Z0000","M810","R4182","Z0001","Z96641","H2513","Z23","H6121","R6889","J029","Z13820","M8580","M25561","M1711","Z86010","I83811","I83891","I83813","I83893","Z13220","Z1329","L719","I8393","I83812","I83892"],"date":["2023-09-08","2023-11-13","2023-11-13","2023-11-13","2023-01-19","2025-09-03","2025-09-18","2023-11-01","2025-09-03","2023-11-29","2023-08-16","2023-09-08","2024-11-27","2023-09-08","2024-12-03","2023-11-21","2023-09-08","2023-11-21","2023-09-22","2023-11-29","2024-12-27","2023-11-28","2024-08-19","2023-01-08","2022-11-18","2022-11-18","2022-11-18","2022-11-18","2022-06-21","2022-03-14","2022-03-14","2022-03-02","2022-03-02","2021-11-12","2021-11-12","2021-11-17","2021-11-17","2022-02-22","2022-02-22"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","ADACEL TDAP","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","OXYCODONE HCL","","","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":""}]}]}