{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Virginia S Cunningham","gend":1,"currentgend":"","add":"339 CASTINE RD","city":"CASTINE","state":"ME","zip":"04421","dob":"1953-06-17","age":"","mstatus":"","insh":"10000061185","cliId":"","pno":2074609032,"cno":2078124735,"email":"SNAPPY2@ROADRUNNER.COM","ename":"","eno":"","pphy":"TAINTER, RUTH B","ppno":2076672288,"pcpadd":"Bucksport Regional Health Center,37 Commerce Park","pcpcity":"Bucksport","pcpstate":"ME","pcpzip":"04416","pcpcounty":"","pcpid":"","pcpname":"BUCKSPORT REGIONAL HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"339 CASTINE RD","madd2":"","madd3":"","mcity":"CASTINE","mstate":"ME","mzip":"04421","pcpfaxno":2076676888,"pcpnpi":1134438625,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1J02FE7TM18","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R9431","T85694A","N179","R739","E8342","S31109A","I214","S42292A","I951","I10","E119","M542","S0990XA","I21A1","N390","E113513","S42202D","I959","N3000","S31109D","M1711","Z4800","L0390","S31101A","F324","E1100","E8720","E860","S31103","S31103A","L89323","E1122","S31104A","S42212A","S4991XA","L03311","E11622","R5381","F329","E785","T8572XA","E1110","S42212D","L089","Y741","Y92009","S42202A","X58XXXA","R55","T148XXA","Z5900","S31101D","B372","E11628","L0889","Z794","Z7984","R7989","S42272D","K659","L98499","Y999","E118","E871","L03313","W010XXA","R54","E1165","A419","S8002XA","S31105A","K8020","E669","I4510","K651","I6523","E11649","E66811","D709","F32A","Z09","E611","D509","L98491","M1991","M7121","M25561","E113519","T8130XD","T8141XD","L98492","Z780","M85831","E11319","S42255D","Z0101","H5203","E113293","S31102D","T8141XA","E875","S40029A","W228XXA","N950","W1839XA","W19XXXA","Y9301","Y92002","S3092XD","Y998","S8991XA","L02211","S31101S","S31100S","T8572XS","S2232XA","E869","R296","R079","S199XXA","Z23","T8130XA","Y828","L0291","Z9641","S3991XA","S3993XA","A4189","S0093XA","S161XXA","S7002XA","S90812A","S42213A","R6889","U071","Z0000","R42","R748","S299XXA","Z6830","R52","M84422A","S8992XA","S80211A","W108XXA","S79912A","R059","Z13820","S42292D","M1612","R112","R197","R0902","Z8781","R519","W1812XA","Z4801","R2689","M79622","M25552","D3501","R609","L989","E559","E6601","F325"],"date":["2024-05-31","2023-05-17","2023-07-13","2024-05-06","2025-03-05","2025-05-06","2023-10-01","2023-03-23","2024-05-19","2023-10-10","2025-01-16","2024-11-27","2024-11-27","2023-08-24","2024-10-16","2023-08-24","2023-11-07","2024-09-17","2023-08-08","2025-06-04","2024-12-16","2025-02-05","2023-07-13","2023-10-04","2024-09-26","2024-06-27","2023-08-04","2023-08-04","2023-08-04","2023-12-04","2023-11-01","2025-04-08","2023-04-03","2023-03-23","2023-02-27","2024-12-05","2025-05-07","2023-03-17","2023-03-17","2023-03-17","2024-12-05","2022-12-06","2023-06-19","2024-12-08","2023-05-17","2023-05-17","2023-06-22","2023-06-22","2023-09-22","2024-05-06","2024-05-06","2025-04-02","2025-03-26","2023-07-10","2023-07-10","2025-04-14","2023-07-10","2023-08-29","2023-11-07","2024-12-08","2025-03-05","2025-03-05","2022-11-03","2024-12-25","2022-11-27","2023-04-05","2023-03-10","2025-04-14","2024-10-16","2023-04-05","2023-03-06","2025-03-05","2024-08-02","2023-07-08","2022-11-30","2022-11-30","2025-04-14","2025-04-14","2024-12-25","2024-08-08","2025-01-02","2023-09-11","2023-09-11","2025-04-08","2023-10-21","2023-10-21","2023-12-01","2023-09-29","2024-08-07","2025-07-02","2023-02-15","2023-12-14","2023-12-14","2025-02-21","2023-03-15","2024-09-03","2024-09-03","2024-09-03","2024-03-06","2023-07-07","2024-09-24","2023-02-27","2023-02-27","2022-12-05","2023-03-08","2024-11-27","2023-03-23","2023-03-23","2024-11-27","2022-12-16","2024-10-16","2023-06-28","2023-06-28","2023-06-28","2023-06-28","2023-04-21","2023-04-21","2023-04-21","2023-02-28","2024-04-30","2022-10-20","2023-03-04","2023-03-04","2022-12-12","2023-08-08","2022-11-27","2022-11-27","2024-10-16","2024-11-27","2024-11-27","2024-11-27","2024-11-27","2023-03-27","2024-10-16","2024-10-16","2022-10-20","2023-02-23","2023-05-23","2023-08-12","2024-12-30","2024-04-30","2023-03-17","2024-10-16","2024-10-16","2024-10-16","2024-10-16","2024-10-16","2023-12-14","2023-05-11","2024-11-27","2023-02-23","2023-02-23","2023-02-23","2023-06-22","2024-04-30","2024-04-30","2022-12-16","2023-04-05","2023-04-05","2024-11-27","2023-06-21","2022-09-29","2022-09-29","2022-06-07","2022-03-29","2022-03-29"],"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":[["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","TRESIBA FLEXTOUCH U-200","","","Select","Select",""],["","","INSULIN ASPART FLEXPEN","","","Select","Select",""],["","","PAROXETINE HCL","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","INSULIN DEGLUDEC PEN (U-200)","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","MIDODRINE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","CICLOPIROX","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","INSULIN GLARGINE SOLOSTAR","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","CEFUROXIME","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ACCU-CHEK FASTCLIX LANCET DRUM","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","UNIFINE PENTIPS","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","ONETOUCH DELICA","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}