{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Marie V Barratt","gend":1,"currentgend":"","add":"29 WILDERNESS SHORE RD S","city":"STEUBEN","state":"ME","zip":"04680","dob":"1947-08-07","age":"","mstatus":"","insh":"10000074776","cliId":"","pno":2076698219,"cno":"","email":"","ename":"","eno":"","pphy":"BARBEE, KRISTEN","ppno":2075462391,"pcpadd":"ONE MEDICAL CENTER DRIVE,","pcpcity":"BIDDEFORD","pcpstate":"ME","pcpzip":"04005","pcpcounty":"","pcpid":"","pcpname":"MILBRIDGE MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 35","madd2":"","madd3":"","mcity":"STEUBEN","mstate":"ME","mzip":"04680","pcpfaxno":2072846291,"pcpnpi":1215166533,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5TF4NN5RT67","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N3281","G8929","Z1231","S62307D","M9900","M9901","M9902","M9903","H40013","H04123","H02401","M26601","Z780","M542","M9907","Z1211","Z4789","G5601","M720","Z23","J40","S61411A","S0083XA","S62306A","W010XXA","Z0001","Z0000","H608X3","Z789","M65331","J3489","M25511","M9904","S62347A","K219","W010XXD","J0190","J209","H903","W1800XA","R300","Z4689","S62309A","S61419A","S4292XA","R58","E785","S6992XA","J9811","N3941","H905","J310","J342","M19011","M19012","M79602","M79601","S62317D","D125","S63213A","S0591XA","S0990XA","S199XXA","S62307A","S99922A","Z98890","N390","W06XXXA","K760","R399","S70261A","M19041","K5730","K641","M9909","Z79899","W19XXXA","M25512","M5450","M25552","M79603","M546","M24541","M62838","M9908","Z139","R490","R0982","K5900","W57XXXA","H9311","H9325","M65341","M20022"],"date":["2025-04-23","2024-07-02","2025-07-17","2025-03-07","2025-06-05","2025-06-05","2025-06-05","2025-06-05","2025-06-09","2024-07-12","2024-10-29","2023-11-21","2024-07-16","2025-05-06","2025-02-20","2025-09-04","2024-07-11","2024-07-11","2024-07-11","2024-10-14","2024-09-06","2024-12-20","2024-12-20","2024-12-20","2024-12-20","2025-03-10","2025-03-18","2025-03-12","2024-03-05","2024-02-16","2023-03-01","2025-05-14","2025-04-08","2025-01-10","2025-04-25","2025-03-07","2024-08-20","2024-08-20","2023-03-01","2025-01-10","2023-03-21","2025-01-23","2024-12-23","2024-12-23","2024-12-20","2025-09-10","2024-03-05","2024-12-20","2024-08-20","2024-03-12","2025-03-12","2024-09-06","2024-03-13","2025-05-20","2025-05-20","2024-04-23","2024-04-23","2025-01-10","2025-09-04","2023-04-24","2024-12-20","2024-12-20","2024-12-20","2025-03-07","2023-02-14","2024-04-11","2023-02-14","2023-02-14","2025-03-24","2023-02-14","2024-04-05","2023-04-24","2025-09-04","2025-09-04","2024-02-22","2025-04-23","2025-05-14","2025-05-14","2024-08-13","2024-08-13","2025-06-05","2023-05-09","2023-05-09","2023-03-09","2025-02-20","2025-04-23","2025-03-14","2025-03-14","2025-03-14","2024-04-05","2022-10-31","2022-10-31","2024-02-16","2022-10-11"],"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":[["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","SOLIFENACIN SUCCINATE","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","CEFUROXIME","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","MYRBETRIQ","","","Select","Select",""],["","","GEMTESA","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}