{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joyce M Scally","gend":1,"currentgend":"","add":"3 STILLSON ST","city":"SANFORD","state":"ME","zip":"04073","dob":"1946-12-28","age":"","mstatus":"","insh":"10000064254","cliId":"","pno":2073248513,"cno":"","email":"joycescally@yahoo.com","ename":"","eno":"","pphy":"JAMES, HOLLY B","ppno":2073050965,"pcpadd":"Village Family Health Care,1 Brickyard Ln Ste EE","pcpcity":"York","pcpstate":"ME","pcpzip":"03909","pcpcounty":"","pcpid":"","pcpname":"VILLAGE FAMILY HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 647","madd2":"","madd3":"","mcity":"SANFORD","mstate":"ME","mzip":"04073","pcpfaxno":2077705800,"pcpnpi":1144283482,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1HA5E05VY88","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0101","H5213","H3540","H43393","H25813","U099","K219","R5382","M810","K862","Z0000","H1132","R413","B349","D485","M85832","M8588","Z01818","N950","I6781","R519","N840","N9489","M19072","M2012","H16042","I862","G8929","R102","R109","L568","L720","C44729","T1512XA","H5712","R0789","N281","K7689","R9082","N644","S065XAA","R059","I700","L309","L578","D225","L814","L820","L538","F411","R202","G459","I6202","I6523","K582","R110","R1031","L218","G454","Q2110","R001","N6311","K580","R739","R0781","M5459","N938","M51360","M47816","M79605","D259","N854","H16142","N2889","N251","Z7189","M79672","K589","G4709","E782","G9331","R030","E46","Z1231","U071","J029","J020","M8580","R6889","E638","M25552","F329","L821","Z1283"],"date":["2025-03-19","2025-03-19","2023-07-26","2023-07-26","2023-07-26","2025-07-21","2025-07-21","2025-07-21","2025-07-21","2024-07-28","2025-04-17","2023-06-27","2025-08-23","2025-01-31","2025-03-05","2025-05-21","2025-05-21","2024-03-06","2025-02-12","2025-08-22","2025-08-22","2025-02-12","2025-03-06","2025-06-17","2025-03-20","2024-01-10","2025-02-11","2025-02-11","2025-02-11","2025-02-11","2025-03-05","2024-01-08","2023-08-11","2024-03-29","2024-03-29","2025-11-13","2024-07-28","2024-07-28","2025-11-13","2023-10-26","2025-11-13","2025-08-23","2025-01-31","2025-01-28","2025-03-05","2025-01-28","2025-01-28","2025-01-28","2025-01-28","2023-03-29","2023-06-19","2025-08-22","2025-08-23","2025-08-22","2023-05-25","2023-05-25","2023-05-25","2022-12-13","2025-10-20","2025-10-20","2025-08-27","2023-07-12","2025-10-20","2023-03-27","2023-06-20","2025-03-06","2023-09-28","2025-03-06","2025-03-06","2023-09-28","2023-09-28","2023-09-28","2024-06-20","2024-01-29","2024-01-29","2025-03-05","2025-03-06","2024-03-13","2024-06-20","2023-11-14","2022-11-16","2022-11-16","2022-11-16","2022-10-10","2022-09-19","2022-09-18","2022-09-05","2022-08-18","2022-08-11","2022-07-20","2022-06-28","2022-06-30","2022-06-21","2022-06-21"],"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":[["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","MISOPROSTOL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","TACROLIMUS","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}