{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Debra A Littlefield","gend":1,"currentgend":"","add":"13 HONAN RD","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1954-12-10","age":"","mstatus":"","insh":"10000070810","cliId":"","pno":2078380412,"cno":"","email":"dawn_gypsy@hotmail.com","ename":"","eno":"","pphy":"STEELE, ERIK N","ppno":"","pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"13 HONAN RD","madd2":"","madd3":"","mcity":"SCARBOROUGH","mstate":"ME","mzip":"04074","pcpfaxno":2078287850,"pcpnpi":1538176789,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7K72GJ5MX24","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C3411","C3491","J9601","I2510","I10","E119","Z5111","Z5112","J189","J9600","J90","R918","I429","I7120","M9900","M9901","M9902","J984","R0902","C7931","J449","M5450","R530","R21","M9903","M9904","E782","Z1231","J069","N819","R590","C771","C3490","L570","L821","L814","Z85820","E1169","I214","Z0100","A419","Z515","J9621","E860","N8110","N952","N8189","J9611","I2102","R0600","R630","D649","Z4682","J982","J9811","I517","I5189","I318","L918","E785","R718","H02059","C7800","R079","R000","Z85118","F17200","K219","R4182","R5383","Z79899","R0602","G9389","L509","L308","E1142","M159","R0989","I119","I509","K5730","Z23","I080","I77810","N3941","R3915","N8111","R748","H903","J9801","C778","C7801","C7802"],"date":["2025-08-27","2025-08-27","2024-12-20","2025-05-06","2025-06-23","2025-05-02","2025-08-27","2025-08-27","2025-04-27","2025-08-27","2024-12-23","2025-01-14","2025-06-06","2025-01-09","2025-09-05","2025-09-05","2025-09-05","2024-09-20","2024-09-25","2025-06-04","2025-06-04","2025-09-05","2025-05-14","2025-05-02","2023-03-03","2023-03-03","2025-05-06","2024-02-16","2025-04-11","2024-09-20","2024-09-25","2024-09-25","2025-07-14","2025-03-20","2024-01-17","2024-01-17","2024-01-17","2024-09-06","2024-12-23","2024-03-15","2025-01-15","2025-03-12","2025-01-18","2025-08-21","2024-06-17","2024-06-17","2024-06-17","2025-03-12","2025-03-12","2025-03-12","2025-03-12","2025-01-18","2024-12-21","2024-12-21","2024-12-20","2024-12-23","2024-12-23","2024-12-23","2023-01-18","2024-07-05","2025-01-13","2025-07-11","2025-01-15","2024-12-19","2025-01-14","2025-07-09","2024-09-25","2024-09-25","2024-09-25","2024-07-12","2025-07-16","2025-01-14","2024-12-17","2023-11-04","2023-11-09","2024-06-28","2024-06-28","2025-01-14","2024-06-28","2024-12-28","2025-04-21","2022-10-07","2023-12-15","2023-12-15","2024-02-26","2024-02-26","2024-02-26","2025-05-13","2025-03-27","2024-09-23","2024-10-22","2024-10-22","2024-10-22"],"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":[["","","BETAMETHASONE DIPROP AUGMENTED","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FREESTYLE LIBRE 2 SENSOR","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","LEVEMIR FLEXPEN","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","ULTRA-FINE SHORT PEN NEEDLE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","FREESTYLE LIBRE 14 DAY READER","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","BRILINTA","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","LEVEMIR FLEXTOUCH","","","Select","Select",""],["","","TICAGRELOR","","","Select","Select",""],["","","UNIFINE PENTIPS","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","GLIPIZIDE","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FREESTYLE LIBRE 14 DAY SENSOR","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","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":""}]}]}