{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cheryl A Stanhope","gend":1,"currentgend":"","add":"89 HOLT RD","city":"CLINTON","state":"ME","zip":"04927","dob":"1950-12-21","age":"","mstatus":"","insh":"10000063377","cliId":"","pno":2076923530,"cno":"","email":"Cherrr321@gmail.com","ename":"","eno":"","pphy":"BANKS PAULINO, ANGELA R","ppno":2074740905,"pcpadd":"Redington Medical Primary Care,46 Fairview Ave Primary Care Ste 111","pcpcity":"Skowhegan","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"REDINGTON MEDICAL PRIMARY CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"89 HOLT RD","madd2":"","madd3":"","mcity":"CLINTON","mstate":"ME","mzip":"04927","pcpfaxno":2074746930,"pcpnpi":1942795885,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1MP8JC4CX28","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I4811","I4891","E876","H2512","Z961","H524","Z0101","M23311","M23351","M25461","J90","K760","S8991XA","Z0000","I4819","I5023","Z111","I10","S72141A","S72141D","S83241D","W1830XS","M25561","R600","D649","R531","Z743","R1310","R079","S72001A","Z4789","K222","I429","E871","R2681","M79604","Z434","I6501","I21A1","I499","M1711","M80051A","E785","Z1231","M25551","I4820","I083","I77810","Z95818","I501","K5730","K8020","R911","I350","R739","Z4682","J811","R002","S71001A"],"date":["2025-09-19","2025-09-19","2025-07-10","2023-07-24","2023-04-18","2023-04-18","2023-04-18","2024-06-27","2024-06-27","2024-06-27","2025-09-26","2025-09-26","2024-06-26","2025-05-01","2025-09-25","2025-09-25","2024-07-08","2025-09-24","2024-06-28","2024-11-13","2024-07-29","2024-07-29","2024-09-06","2024-08-30","2025-06-13","2024-07-18","2025-09-19","2025-09-23","2025-09-26","2025-03-04","2024-07-22","2025-09-23","2025-09-17","2024-07-07","2024-07-18","2024-06-26","2025-09-26","2025-09-17","2024-08-06","2025-09-21","2024-11-13","2024-06-29","2023-04-21","2024-05-14","2025-01-02","2024-06-26","2025-09-26","2025-09-26","2025-09-26","2025-09-26","2025-09-23","2025-09-26","2025-09-23","2025-09-21","2024-05-07","2025-09-26","2025-09-26","2025-09-19","2024-07-07"],"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":[["","","AMIODARONE HCL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","TRIAMTERENE-HYDROCHLOROTHIAZID","","","Select","Select",""],["","","MULTAQ","","","Select","Select",""],["","","TRAMADOL 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":""}]}]}