{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Diana Johnson","gend":1,"currentgend":"","add":"704 ISLAND AVE.","city":"LONG ISLAND","state":"ME","zip":"04050","dob":"1955-10-02","age":"","mstatus":"","insh":"10000079865","cliId":"","pno":2072324091,"cno":"","email":"Teagued1@outlook.com","ename":"","eno":"","pphy":"CONNOLLY, PATRICK J","ppno":2078282402,"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":"704 ISLAND AVE.","madd2":"","madd3":"","mcity":"LONG ISLAND","mstate":"ME","mzip":"04050","pcpfaxno":2078282425,"pcpnpi":1982655098,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2Q80T61QV13","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":["R109","R918","K5710","K224","R112","R1013","C221","D381","Z5111","C801","Z1231","C3492","L821","D1801","L720","Z0101","S3992XA","S3993XA","Z1211","Z5112","Z48813","L570","Z13220","R5383","M109","Z13228","M5412","Z23","D120","R195","D123","R110","R911","C7800","C50919","C50911","D701","J8410","K317","M62838","K2970","Z720","F32A","Z98890","R300","C50912","C50411","G893","R6889","K3189","R928","F418","G4700","R4182","K838","C3432","R079","D649","Z79899","K319","C3490","Z853","Z85118","R197","Z170","C773","Z01818","Z733","K5730","Z860100","R634","N6311","M799","C7801","J90","F17200","N6331","M85852","F411","F17210","C799","Z483","Z860101","M50122","M4722","J189"],"date":["2023-11-28","2025-11-12","2023-09-27","2023-09-27","2025-04-15","2024-01-26","2025-10-14","2024-11-27","2025-07-23","2025-11-17","2024-07-26","2025-01-16","2025-09-22","2025-09-22","2025-09-22","2025-06-09","2023-07-06","2023-07-06","2025-01-13","2025-09-16","2024-11-27","2023-09-13","2024-06-11","2025-05-13","2023-08-29","2024-06-11","2024-08-30","2024-08-30","2023-10-27","2023-10-27","2023-10-27","2024-01-26","2025-11-12","2025-11-17","2025-01-16","2025-10-14","2025-06-11","2025-11-12","2025-01-15","2025-01-12","2023-08-29","2023-08-29","2023-08-29","2025-01-03","2024-08-15","2024-09-25","2024-11-18","2025-09-02","2023-04-01","2023-12-06","2024-08-21","2024-10-01","2024-10-01","2024-10-01","2025-01-15","2025-02-10","2025-11-17","2025-07-01","2025-08-04","2023-08-29","2025-01-03","2025-11-03","2025-01-03","2023-12-06","2024-10-01","2024-10-01","2024-09-25","2023-07-06","2025-01-13","2025-01-13","2023-12-06","2024-08-21","2024-11-18","2024-12-05","2025-06-20","2024-08-27","2025-11-03","2024-10-21","2023-08-29","2023-08-29","2025-11-12","2024-10-24","2025-01-13","2024-08-30","2024-08-30","2022-11-18"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","FENTANYL","","","Select","Select",""],["","","ANASTROZOLE","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","CREON","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","LOPERAMIDE","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","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":""}]}]}