{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sheryl J Olson","gend":1,"currentgend":"","add":"16 BREARY AVE APT C12","city":"Sanford","state":"ME","zip":"04073","dob":"1952-01-09","age":"","mstatus":"","insh":"10000075474","cliId":"","pno":2072983167,"cno":"","email":"kisholson@gmail.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":"16 BREARY AVE APT C12","madd2":"","madd3":"","mcity":"Sanford","mstate":"ME","mzip":"04073","pcpfaxno":2078287850,"pcpnpi":1538176789,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6PK1K03TW24","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":["R079","R1030","Z01818","M79601","M1612","F411","Z79899","G90511","N200","K5730","Z471","M1611","I639","E782","E785","Z23","I2510","I10","Z8673","E559","Z0101","M25552","K047","F418","Z955","S199XXA","S0990XA","Z8679","S060XAA","R262","I25118","S79912A","S3993XA","R931","I080","S00531A","I499","G8929","M13852","Z87891","Z5321"],"date":["2023-02-03","2025-06-26","2024-11-05","2023-07-31","2024-11-21","2023-04-12","2023-04-12","2025-03-20","2025-06-26","2025-06-26","2024-11-23","2024-11-21","2023-01-27","2025-07-03","2024-02-01","2024-02-05","2024-11-21","2024-02-01","2023-01-29","2023-02-07","2025-05-21","2024-04-02","2024-04-18","2024-11-21","2024-11-21","2023-01-26","2023-01-26","2023-01-31","2023-01-31","2024-11-21","2023-06-22","2024-04-02","2023-01-26","2023-01-30","2023-01-30","2023-01-26","2025-06-26","2024-04-02","2024-04-02","2024-04-02","2022-09-27"],"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":[["","","TRAMADOL HCL","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","PENICILLIN V POTASSIUM","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}