{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda A Oconnor","gend":1,"currentgend":"","add":"6 PAXTON WAY","city":"WINDHAM","state":"ME","zip":"04062","dob":"1949-09-17","age":"","mstatus":"","insh":"10000078299","cliId":"","pno":2078922176,"cno":"","email":"laoconn@myfairpoint.net","ename":"","eno":"","pphy":"ATKINSON, CYNTHIA A","ppno":2077745816,"pcpadd":"100 GANNETT DRIVE,SUITE C","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 PAXTON WAY","madd2":"","madd3":"","mcity":"WINDHAM","mstate":"ME","mzip":"04062","pcpfaxno":2078741483,"pcpnpi":1487753125,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2AQ0PQ8KN21","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["A419","Z0001","I110","I5033","K265","B9681","Z736","Z1231","Z952","Z7901","M810","R109","E871","K269","K1121","K449","H25813","H43813","E785","D509","M8580","I10","K821","K838","R194","R531","K219","J029","R051","R918","I350","D492","I509","K8689","Z0000","Z23","A000","R262","R399","K2970","Z8711","N6489","I5189","R609","Z9181","L600","L980","L03041","M79674","I340","H0014","H25812","H3563","Z0101","H02403","H02831","H02834","H61001","L578","R300","H2512","H2511","R112","R197","M50321","M47812","G939","K1120","S060X0A","R202","H259","E781","I3481","I342","K668","K5901","K921","R4182","R0602","Z4682","K5989","H25811","K279","R7989","R413","R600","N907","D649","B351","M79675","I8003","L84","I8001","M79671","L570","R7309","T300","L590","D500","E7849","L609","R4789","R29898","Z1211","R4781","F331","R238","M961","L03031","R785","I083","I5030","Z953","Z79899","H9201","Z5181"],"date":["2025-01-21","2025-08-20","2025-03-17","2025-02-14","2025-02-14","2025-02-14","2025-02-14","2024-10-31","2025-10-16","2025-10-16","2025-10-29","2023-10-20","2023-09-12","2025-04-16","2024-09-13","2025-11-04","2023-09-18","2023-09-18","2025-08-26","2024-08-19","2024-08-19","2025-10-24","2023-09-12","2023-10-20","2023-08-10","2025-01-30","2025-11-04","2023-08-21","2023-03-22","2025-01-26","2025-10-24","2025-08-11","2025-02-22","2023-10-20","2023-08-10","2025-10-07","2025-02-15","2025-02-14","2024-01-31","2025-05-01","2025-05-01","2024-12-05","2023-04-27","2023-04-27","2023-04-27","2024-06-20","2023-06-13","2023-06-13","2023-06-13","2025-01-24","2024-11-12","2023-12-19","2025-07-09","2025-01-09","2024-11-12","2024-11-12","2024-11-12","2024-12-17","2024-11-14","2024-02-01","2023-12-19","2023-12-05","2025-01-30","2025-01-20","2023-04-14","2023-04-14","2023-04-14","2024-09-23","2023-04-14","2023-07-24","2023-12-19","2023-10-26","2025-01-24","2025-01-24","2025-01-24","2025-01-13","2025-01-13","2025-01-20","2025-01-23","2025-01-21","2025-01-21","2023-12-05","2025-05-01","2023-02-24","2023-02-09","2023-02-09","2023-02-09","2025-10-02","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2022-12-20","2025-08-11","2023-02-09","2024-07-01","2024-07-01","2022-12-29","2025-10-24","2022-11-11","2022-09-28","2022-09-28","2022-09-22","2022-09-28","2022-08-18","2022-08-22","2022-08-08","2022-08-29","2022-08-18","2022-08-01","2022-08-01","2022-08-01","2022-06-09","2022-03-29","2022-03-23"],"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":[["","","TETRACYCLINE HCL","","","Select","Select",""],["","","MORPHINE SULFATE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","MORPHINE SULFATE ER","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","SILVER SULFADIAZINE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","NITROFURANTOIN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","SHINGRIX","","","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":""}]}]}