{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda A Johnson","gend":1,"currentgend":"","add":"87 MUSSY ST","city":"SOUTH PORTLAND","state":"ME","zip":"04106","dob":"1955-08-17","age":"","mstatus":"","insh":"10000079057","cliId":"","pno":6176948543,"cno":"","email":"Ellejohnson84@gmail.com","ename":"","eno":"","pphy":"MCBRADY, MEGAN E","ppno":2078469013,"pcpadd":"InterMed,259 Main St","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"87 MUSSY ST","madd2":"","madd3":"","mcity":"SOUTH PORTLAND","mstate":"ME","mzip":"04106","pcpfaxno":2075238586,"pcpnpi":1164868964,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5HN7YE7AM20","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R030","Z96651","M25561","G8918","M1712","R112","Z98890","E039","L821","D225","D1801","L814","G4733","M9903","M5416","M9904","M5417","Z471","F5101","Z96652","N3281","Z0101","M25462","Z1211","Z83719","G4730","R7989","Z01818","Z01810","M170","R6889","M5431","M5430","Z0000","E559","M1711","Z23","Z87891","F32A","Z1231","L659","Z79890","Z791","Z79899","R7301","F1020","R8290","R42","L649","Z124","R109","R1032","Z0001","Z03818","L237","J069","Z780","R059","R0683"],"date":["2024-02-29","2023-06-29","2023-06-29","2023-04-03","2022-12-19","2023-04-03","2023-04-03","2025-10-21","2025-01-30","2025-01-30","2025-01-30","2025-01-30","2025-09-02","2025-01-28","2025-01-28","2025-01-28","2025-01-28","2023-05-31","2024-07-30","2023-02-24","2022-12-02","2024-11-06","2023-01-03","2024-04-17","2024-04-17","2024-04-17","2025-10-21","2023-03-03","2022-12-02","2022-12-02","2023-09-27","2025-02-18","2024-12-18","2025-10-21","2025-10-21","2023-04-03","2025-10-27","2022-12-19","2022-12-19","2024-04-04","2025-03-25","2023-04-03","2023-04-03","2023-04-03","2024-10-04","2025-10-21","2024-01-24","2024-01-24","2025-04-03","2024-10-11","2022-11-21","2022-10-04","2022-09-27","2021-11-21","2021-11-21","2021-11-21","2021-12-16","2022-01-07","2022-01-20"],"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":[["","","CITALOPRAM HBR","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","SCOPOLAMINE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","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":""}]}]}