{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Janice E Stockson","gend":1,"currentgend":"","add":"402 JACOB AVE","city":"Scarborough","state":"ME","zip":"04074","dob":"1955-09-12","age":"","mstatus":"","insh":"10000079483","cliId":"","pno":2077674484,"cno":2076156440,"email":"gary_stockson@yahoo.com","ename":"","eno":"","pphy":"HEARD CUSHING, KAREN S","ppno":2077745816,"pcpadd":"InterMed,84 Marginal Way Ste 800","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"402 JACOB AVE","madd2":"","madd3":"","mcity":"Scarborough","mstate":"ME","mzip":"04074","pcpfaxno":2075238597,"pcpnpi":1720421217,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3H45Q70YU60","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R52","R9389","R6889","M542","H2512","E7800","K219","I480","R0602","G250","G241","I10","R5383","E559","H26493","R413","Z0000","I2510","R7989","M546","N1831","H26491","H02833","H02836","J0140","F419","R051","Z03818","R109","Z0100","Z0001","R053","R531","I2720","Z23","R2681","M797","I440","J189","N3289","Z1231","R42","R918","R062","R0600","M5134","M4184","H259","Z0101","J8410","R911","J984","R931","G4733","M75102","Z4789","Z98890","R0609","J40","R059","R609","Z6830","M25512","M79602","M5450","I209","M75122","S46212A","M7542","M66322","M7522","M62838","M67912","R202","M19012"],"date":["2024-09-06","2025-04-19","2023-05-30","2025-09-17","2023-05-02","2025-05-09","2024-05-02","2025-09-08","2023-10-20","2024-11-22","2023-10-20","2025-06-17","2025-05-09","2025-05-09","2024-12-02","2025-06-25","2023-04-14","2025-08-12","2025-05-09","2024-07-10","2024-07-11","2023-04-13","2023-04-13","2023-04-13","2025-01-23","2025-01-23","2025-02-11","2025-02-11","2025-01-16","2024-12-30","2025-05-14","2025-02-25","2025-02-25","2025-09-05","2025-05-14","2023-08-04","2023-08-04","2025-08-12","2025-04-10","2024-06-18","2025-01-08","2024-11-22","2025-02-25","2025-02-19","2023-02-27","2024-06-27","2024-06-27","2023-05-02","2024-10-23","2025-04-19","2025-04-19","2025-02-11","2025-09-05","2023-02-07","2022-09-14","2022-09-14","2022-09-14","2022-09-26","2022-08-05","2022-07-30","2022-07-06","2022-07-06","2022-05-26","2022-05-26","2022-03-30","2022-04-04","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-04-08","2022-03-12","2022-03-18","2022-01-11","2022-02-15"],"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":[["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","NADOLOL","","","Select","Select",""],["","","FLECAINIDE ACETATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","BOTOX","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","MEDROXYPROGESTERONE ACETATE","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","FLUARIX QUAD 2021-2022","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","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":""}]}]}