{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Debra A Sheerer","gend":1,"currentgend":"","add":"28 GROVER LN","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1955-10-18","age":"","mstatus":"","insh":"10000079736","cliId":"","pno":2077290479,"cno":"","email":"","ename":"","eno":"","pphy":"BAIER, ROBIN","ppno":2077984400,"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":"28 GROVER LN","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":2078287850,"pcpnpi":1891189288,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9XH2K02CW21","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":["Z23","E875","J849","S72492D","J8410","I2510","I3481","K449","E785","E559","G4733","S72492A","Z720","Z736","J9601","M9712XD","M85851","N289","D649","S72402D","S72491G","I10","J449","M8588","S7292XA","R52","Z743","G43B0","M25562","S72402A","E119","G4710","G4730","Z01818","Z1231","I517","R0602","M1711","M25461","S72352A","M79605","H5213","Z0101","M25561","S72452A","M9712XA","X58XXXA","Z1211","R942","D122","D123","M1812","D509","K219","F418","R4182","H52223","R918","R0902","G8918","S72002A","R110","H6693","J209","M7989","R062","F909","Z860100","R1084","I878","E1151","M19241","R059","M150","F3342","Z79899","Z0000"],"date":["2025-10-17","2025-05-30","2025-03-19","2025-10-23","2024-12-10","2024-12-10","2025-07-09","2024-12-10","2025-05-20","2025-05-20","2025-10-01","2025-08-19","2024-09-06","2025-10-23","2025-10-23","2025-10-23","2024-09-30","2025-08-27","2025-10-17","2025-10-02","2025-07-06","2025-07-06","2025-07-07","2024-09-30","2025-07-14","2025-07-06","2025-07-14","2023-06-15","2025-07-06","2025-07-07","2025-09-03","2024-09-06","2024-09-06","2025-07-07","2024-03-07","2025-07-09","2025-07-09","2024-03-13","2024-03-13","2025-07-06","2025-07-06","2023-07-20","2025-09-03","2024-03-13","2025-07-07","2025-07-07","2025-07-07","2024-12-31","2025-03-19","2024-12-31","2024-12-31","2025-07-15","2024-12-31","2025-07-07","2024-12-31","2024-12-31","2025-09-03","2025-07-08","2025-07-08","2025-07-07","2025-07-24","2024-06-02","2024-05-21","2024-05-21","2024-05-21","2024-05-21","2023-06-13","2024-12-31","2024-06-02","2024-06-02","2024-04-11","2024-04-11","2022-11-08","2022-10-18","2022-10-18","2022-06-09","2022-06-09"],"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":[["","","BREO ELLIPTA","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHETAMINE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUTICASONE-VILANTEROL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","VARENICLINE TARTRATE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}