{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Wanda L Lessard","gend":1,"currentgend":"","add":"137 SEWALL ST","city":"Augusta","state":"ME","zip":"04330","dob":"1954-10-01","age":"","mstatus":"","insh":"10000070267","cliId":"","pno":2073128630,"cno":2073128630,"email":"wandallessard@gmail.com","ename":"","eno":"","pphy":"GUZZETTI, PETER D","ppno":2076238434,"pcpadd":"Kennebec Internal Medicine,9 Glenridge Dr","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"KENNEBEC INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"137 SEWALL ST","madd2":"","madd3":"","mcity":"Augusta","mstate":"ME","mzip":"04330","pcpfaxno":2076214370,"pcpnpi":1306885207,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4GG1GE3YG19","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R000","I4892","Z789","Z5181","Z7901","I4891","M9903","M5450","M62830","J329","J3801","R490","J384","I422","I517","Z953","J90","J029","I442","J209","Z950","M1611","M7071","I421","I340","K219","D141","M160","I878","M25551","R739","I10","R5383","E785","M720","Z0000","Z952","I480","D72829","R0602","R0902","R319","J9601","Z48812","Z4659","J811","Z13820","N951","I214","J189","J440","Z780","I071","Z452","R918","M65341","R599","R0600","Z01810","G4700","F419","D649","R21","R570","R569","Z09","I6523","I270","Z48813","Z136","R931","L80","L570","I2720","I3481","I3489","R079","R4182","R9401","J810","I499","R911","R531","R1310","Z0100","J939","I088","Z95810","I058","R410","I341","Z959","I4710","I498","R6889","Z1231","I2510","R9431","E663","R590","E278","D224","L821","L814","Z7189","E559","R109","T8209XA","I342","J3800","R011","K635","Z1211","I459","D125","M7061","Z23","R0989","K5520","R195","M159","M79641","G5690","M329","M19042","M19041"],"date":["2025-08-12","2025-09-15","2025-08-12","2025-09-22","2025-11-03","2025-09-22","2024-11-27","2024-11-27","2024-11-27","2023-04-13","2024-12-12","2024-12-12","2023-07-06","2025-08-13","2025-08-13","2025-08-13","2025-08-19","2024-10-22","2025-10-20","2022-12-16","2025-07-24","2025-02-04","2024-12-16","2025-09-30","2025-09-05","2025-08-13","2023-08-25","2024-12-16","2024-12-16","2024-12-16","2025-04-22","2025-08-13","2025-04-22","2025-08-13","2023-02-03","2025-04-28","2025-09-30","2025-09-30","2025-07-13","2025-08-29","2025-08-13","2025-04-22","2025-07-29","2025-08-28","2025-07-20","2025-07-23","2024-04-30","2024-04-08","2025-06-18","2025-06-09","2025-06-09","2024-04-30","2025-08-19","2025-06-13","2025-08-13","2023-04-24","2022-12-30","2025-06-09","2025-07-15","2025-06-23","2025-06-23","2025-07-01","2025-07-01","2025-06-18","2025-07-21","2025-08-13","2025-07-19","2025-06-11","2025-08-14","2025-07-09","2025-07-11","2024-09-18","2025-10-10","2025-07-18","2025-06-16","2025-06-16","2025-08-12","2025-07-21","2025-07-21","2025-06-15","2025-08-13","2024-08-20","2025-06-11","2025-06-17","2025-11-03","2025-07-18","2025-07-11","2025-08-04","2025-07-18","2025-07-21","2025-07-18","2025-08-19","2025-07-23","2025-07-23","2023-11-01","2024-04-29","2024-08-20","2025-07-11","2024-09-26","2023-07-25","2023-07-25","2025-10-10","2025-10-10","2025-10-10","2025-10-10","2025-04-22","2025-08-11","2025-08-12","2025-08-12","2025-07-18","2025-07-24","2023-09-18","2023-09-18","2025-07-24","2023-09-18","2025-05-19","2025-09-23","2025-08-13","2023-09-18","2023-09-18","2022-10-20","2022-09-20","2022-09-06","2022-09-06","2022-08-31","2022-08-31"],"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":[["","","POTASSIUM CITRATE ER","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","WARFARIN SODIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","VERAPAMIL SR","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","DISOPYRAMIDE PHOSPHATE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","TACROLIMUS","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","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":""}]}]}