{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Claudette L Martin","gend":1,"currentgend":"","add":"171 BROOK RD","city":"SAINT AGATHA","state":"ME","zip":"04772","dob":"1946-09-20","age":"","mstatus":"","insh":"10000072802","cliId":"","pno":2075437895,"cno":"","email":"MARTINCLAUDETTE@YMAIL.COM","ename":"","eno":"","pphy":"BRESETT, JENNIFER M","ppno":2077287300,"pcpadd":"460 MAIN ST,SUITE 201","pcpcity":"MADAWASKA","pcpstate":"ME","pcpzip":"47561014","pcpcounty":"","pcpid":"","pcpname":"ACADIA FAMILY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 178","madd2":"","madd3":"","mcity":"ST AGATHA","mstate":"ME","mzip":"04772","pcpfaxno":2077283838,"pcpnpi":1316929672,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2XR1DG2QN12","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I10","I2510","M75101","M12811","M25511","M75121","G8929","Z1231","R6889","K2950","K449","K219","L821","R5383","H353221","H353112","H25813","H43813","K319","Z96611","H353222","Z01818","F411","Z0000","R55","L820","R1032","J45901","Z20822","Z01811","M25562","N390","M25812","M19012","Z471","E2839","M7541","E559","R0789","S76212A","K2289","Z4802","Z0100","M94211","M25512","D492","R933","R079","G8918","E785","Z96619","R059","M19011","R0602","I700","Z1211","R9431","I252","L570"],"date":["2025-04-07","2024-12-16","2024-07-29","2024-07-29","2024-04-11","2024-04-05","2024-04-11","2024-09-03","2023-07-03","2025-08-29","2025-08-29","2025-08-29","2025-06-02","2024-07-02","2023-10-23","2025-06-05","2025-06-05","2025-06-05","2025-08-29","2025-04-17","2025-06-05","2024-03-13","2023-03-12","2024-08-19","2024-07-23","2025-06-19","2025-07-25","2023-11-09","2023-11-09","2024-03-14","2024-08-22","2025-09-04","2023-03-31","2023-03-31","2024-05-16","2025-04-28","2023-06-10","2024-03-05","2023-11-09","2025-07-25","2025-07-28","2025-07-07","2024-10-08","2024-04-05","2023-03-02","2025-06-19","2025-08-12","2024-03-28","2024-04-05","2024-04-05","2024-04-16","2023-11-08","2023-07-19","2022-08-22","2022-09-07","2022-07-08","2022-06-24","2022-06-24","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":[["","","TRETINOIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","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":""}]}]}