{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Concetta S Lane","gend":1,"currentgend":"","add":"597 OSSIPEE TRL W","city":"STANDISH","state":"ME","zip":"04084","dob":"1951-04-22","age":"","mstatus":"","insh":"10000070429","cliId":"","pno":2079949105,"cno":"","email":"april22nana@yahoo.com","ename":"","eno":"","pphy":"NANNICELLI, ANGELEA","ppno":2077998596,"pcpadd":"Martins Point Health Care,153 US Rte 1","pcpcity":"Scarborough","pcpstate":"ME","pcpzip":"04074","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 OAK RIDGE DR","madd2":"","madd3":"","mcity":"STANDISH","mstate":"ME","mzip":"04084","pcpfaxno":2077778800,"pcpnpi":1366253098,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5X16TC4JX58","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M2042","M2012","R5383","Z1159","R911","I509","Z96653","E039","M1712","Z0101","I10","R0602","N950","E6601","R195","C3411","K229","F418","Z6835","M2011","Z1231","R946","R197","E611","E66813","D72810","N938","Z853","Z86718","Z7901","G4719","K760","J029","K909","Z9884","Z6836","D6861","R7989","D485","R945","R053","R0609","G4733","I890","Z48813","J9811","R600","C50911","K529","Z23","C3491","Z4889","R7401","N6489","I878","R079","I209","R918","D492","Z713","J439","K2100","E0590","R2241","L110","R1011","L308","R17","Z136","L0102","L986","K219","I82512","I82412","J449","Z800","Z8719","L309","F3342","Z0000","M109","R221","K5900","M546","G8929","N939","G8922","R0600","R791","N644","K2270","Z98890","Z87891","R748","R760","R590","Z79899","Z1211","E079","M792","L859","K2090","M79661","K449","M62830","K2950","L750","R739","R1310","E669","R4182","Z6841","K5730","Z6838","R0683","I3481","K649","M79621","I517","I351","R161","I700","Z780","R9389","G548","K319","K6389","N858","R1909","R922","Z96652","Z01812","G8918","Z471","A000"],"date":["2024-07-26","2024-07-26","2025-03-11","2024-11-06","2025-04-17","2023-04-27","2022-12-13","2025-10-28","2022-12-19","2025-11-19","2025-10-14","2025-05-07","2023-01-17","2024-05-28","2025-08-19","2025-06-11","2025-10-14","2025-10-14","2025-10-14","2024-07-26","2025-09-17","2024-06-18","2025-08-13","2023-05-10","2025-07-21","2024-11-06","2022-12-28","2025-09-17","2023-08-21","2023-08-21","2023-09-01","2024-11-06","2025-06-03","2025-02-05","2025-05-27","2025-02-04","2023-09-20","2023-07-19","2023-08-01","2024-06-18","2025-07-01","2023-03-21","2025-07-02","2025-11-17","2025-02-26","2025-02-26","2023-05-10","2023-09-06","2025-05-27","2025-11-03","2025-01-16","2024-04-10","2024-11-06","2025-05-20","2023-07-03","2023-03-21","2023-03-21","2025-06-06","2024-01-09","2025-04-15","2025-02-17","2025-10-14","2023-06-26","2023-07-27","2024-01-09","2024-04-23","2024-08-08","2025-10-28","2025-10-28","2024-01-16","2023-08-07","2025-06-25","2023-01-17","2023-05-09","2023-06-28","2025-09-10","2025-05-13","2023-01-03","2024-08-09","2024-08-09","2024-08-09","2024-09-06","2025-09-10","2025-11-19","2025-11-19","2022-12-28","2025-07-01","2023-03-20","2023-03-20","2025-05-20","2025-10-14","2025-02-18","2025-09-10","2024-04-23","2025-01-02","2025-05-16","2024-02-15","2023-03-09","2023-03-09","2025-09-17","2024-01-16","2025-09-10","2023-07-11","2025-07-22","2024-06-18","2025-07-22","2023-02-27","2024-04-10","2023-06-28","2025-02-17","2025-02-17","2023-11-03","2025-07-22","2024-04-10","2024-02-12","2023-06-29","2025-07-22","2025-05-30","2023-03-21","2023-03-21","2025-06-30","2025-05-27","2022-12-28","2022-12-28","2025-06-11","2025-07-22","2025-07-22","2023-01-17","2022-12-26","2022-10-11","2022-10-17","2022-08-07","2022-08-10","2022-08-25","2022-08-12"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","EXEMESTANE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","RESTASIS","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","CHOLESTYRAMINE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","ENOXAPARIN SODIUM","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","LANSOPRAZOLE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","LOTEPREDNOL ETABONATE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","METHOTREXATE","","","Select","Select",""],["","","DUPIXENT PEN","","","Select","Select",""],["","","AFLURIA QUAD 2022-23 (3YR UP)","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":""}]}]}