{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maureen R Campbell","gend":1,"currentgend":"","add":"12 KENSINGTON TERR","city":"LEWISTON","state":"ME","zip":"04240","dob":"1953-09-07","age":"","mstatus":"","insh":"10000059901","cliId":"","pno":2077130232,"cno":2077130232,"email":"gcampbell52@live.com","ename":"","eno":"","pphy":"LATKOVICH, KATARINA Z","ppno":2077955700,"pcpadd":"12 HIGH ST,STE 400 CENTRAL MAINE INTERNAL MEDICINE","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"04240","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"12 KENSINGTON TERR","madd2":"","madd3":"","mcity":"LEWISTON","mstate":"ME","mzip":"04240","pcpfaxno":2077955727,"pcpnpi":1902878499,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6FA4TQ9GV74","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R6889","L820","L538","R413","S81801A","S81821A","I10","Z87891","H35372","H43813","Z1211","Z0000","Z808","Z1231","L570","S81811A","F419","R002","M79604","M25571","R7989","Z5189","H6691","R42","R296","R252","B001","Z8541","J0110","L03115","Z1212","S80851A","M7989","J069","J029","S99911A","L249","Z789","R208","H47233","H2513","L814","D2262","D2261","D2272"],"date":["2023-01-01","2024-12-30","2024-12-30","2023-04-13","2024-08-09","2024-07-06","2024-08-09","2024-07-06","2025-05-01","2025-05-01","2025-05-16","2023-10-23","2022-12-05","2025-04-30","2025-10-07","2024-07-24","2023-10-23","2023-04-13","2024-07-10","2024-08-09","2024-12-10","2024-07-10","2024-01-12","2024-07-12","2024-07-12","2022-12-05","2022-12-05","2023-10-23","2024-01-12","2024-07-13","2025-05-16","2024-07-10","2024-07-10","2023-12-13","2023-12-13","2024-08-09","2023-04-10","2023-04-10","2023-04-10","2022-11-09","2022-11-09","2022-10-10","2022-10-10","2022-10-10","2022-10-10"],"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":[["","","PROPRANOLOL HCL ER","","","Select","Select",""],["","","IRBESARTAN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","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":{"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":[]}},{"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":""}]}]}