{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Marcia E Hanson","gend":1,"currentgend":"","add":"24 PEPPERELL ST","city":"SACO","state":"ME","zip":"04072","dob":"1942-11-19","age":"","mstatus":"","insh":"10000073461","cliId":"","pno":2073238549,"cno":2073323514,"email":"Marchmaydecember2016@gmail.com","ename":"","eno":"","pphy":"MICHAUD, KATHRYN","ppno":2077998596,"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":"24 PEPPERELL ST","madd2":"","madd3":"","mcity":"SACO","mstate":"ME","mzip":"04072","pcpfaxno":2077991730,"pcpnpi":1104353838,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3PT7EJ7UQ45","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":["I2510","I5032","I10","E7800","M542","M47892","M25511","H6123","H16223","H04123","Z466","N812","K5900","M25571","S40022A","R4189","Z79899","R2681","K2971","K449","K219","M549","H26491","M19011","M810","Z7901","R931","R0600","R4182","K769","M6281","R269","S93601A","M47812","Z955","N8110","R0789","Z7902","G8310","R7303","S0003XA","Z7722","R0689","R739","S93401A","N952","H353131","R300","H401111","H401122","Z0101","R413","L821","D0361","K910","N939","M5450","K2970","R0609","K2950","G3184","F419","R918","R42","M79671","R410","Z9861","R7401","E785","I6523","L570","D492","L820","H6121","N816","Z23","R5383","I959","U071","Z01810","H353111","H353122","I5189","R001","I5020","I082","Z515","M797","M50321","M50322","N390","T8389XA","R1032","H903","K644","K5909","K319","M546","K439","Z780","K7689","I361","T8092XA","S199XXA","S99911A","S99921A","R932","A419","R509","R059","J90","Z1389","K5730","J9601","H00021","R109","Z4689","I25119","I110","Z7982","Z01812","Z20822"],"date":["2025-10-15","2025-04-16","2025-10-15","2025-10-15","2023-09-27","2023-05-23","2023-09-27","2025-02-12","2024-06-04","2024-06-04","2025-06-25","2025-06-25","2025-09-18","2024-08-12","2024-08-12","2025-08-25","2024-10-21","2024-10-21","2024-07-31","2025-01-15","2024-12-13","2024-08-19","2024-02-15","2024-02-06","2025-01-30","2024-02-06","2024-03-05","2025-09-08","2024-12-11","2024-08-09","2024-06-03","2023-04-18","2024-08-12","2024-01-02","2024-02-21","2025-10-16","2023-03-07","2023-03-07","2024-04-08","2025-01-30","2024-08-12","2024-08-12","2025-09-08","2022-11-30","2024-08-12","2025-10-16","2024-02-15","2024-11-01","2025-04-23","2025-04-23","2023-12-13","2024-09-09","2025-05-21","2025-06-10","2024-12-20","2024-05-31","2025-06-25","2024-07-31","2023-08-10","2023-11-03","2025-09-12","2023-08-11","2025-01-28","2024-06-03","2023-05-31","2023-07-07","2023-08-17","2024-03-20","2025-01-30","2024-03-06","2025-05-21","2025-05-21","2025-05-21","2025-08-11","2024-07-12","2023-11-01","2023-08-10","2025-02-04","2022-11-26","2024-07-08","2023-12-13","2023-12-13","2023-12-05","2023-12-05","2025-04-16","2025-04-16","2024-09-20","2024-09-20","2022-12-16","2022-12-16","2024-02-29","2025-10-16","2024-08-09","2025-10-17","2025-04-30","2025-04-30","2024-07-31","2024-08-19","2024-08-09","2023-06-15","2023-12-12","2023-06-21","2024-12-11","2024-08-12","2024-08-12","2024-08-12","2022-11-18","2022-11-17","2022-11-17","2022-11-17","2022-11-19","2022-11-11","2022-11-11","2022-11-19","2022-10-05","2022-09-15","2022-08-11","2022-08-18","2022-09-09","2022-08-18","2022-08-15","2022-08-15"],"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":[["","","ESTRADIOL","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","RESTASIS","","","Select","Select",""],["","","IPRATROPIUM BROMIDE","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","RESTASIS MULTIDOSE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","CYCLOSPORINE","","","Select","Select",""],["","","XIIDRA","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","TRUEPLUS LANCETS","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","CAREONE","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","KATERZIA","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","TRUE METRIX","","","Select","Select",""],["","","TRUE METRIX GLUCOSE TEST STRIP","","","Select","Select",""],["","","TRUE METRIX BLOOD GLUCOSE MTR","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","FUROSEMIDE","","","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":""}]}]}