{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Patricia Sloat","gend":1,"currentgend":"","add":"39 BEECH HILL RD","city":"FREEPORT","state":"ME","zip":"04032","dob":"1950-02-16","age":"","mstatus":"","insh":"10000081421","cliId":"","pno":2077511818,"cno":"","email":"patandbryan@comcast.net","ename":"","eno":"","pphy":"MCELHINNEY, KRISTINA 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":"39 BEECH HILL RD","madd2":"","madd3":"","mcity":"FREEPORT","mstate":"ME","mzip":"04032","pcpfaxno":2078741483,"pcpnpi":1497073746,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4PW9RD1TW13","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M549","R531","M722","Z23","Z0000","I10","L918","R208","L821","D1801","R002","E785","D225","R110","L820","D492","N281","Z1231","M65312","M25531","I440","M79671","R262","H00011","I351","M19071","M6580","Z9049","H539","H43812","H2513","Z0101","H5203","I340","I3489","I517","R053","Z03818","J069","Z0001","Z780","R6889","K1321","Z79899","K625","R197","H40013","R42","K921","L738","D2371","Z85828","H16142","S0502XA","R2689","R450","R011","R5383","R251","E8352","K5790","R7309","Z8619","N952","Z124"],"date":["2025-01-06","2025-06-20","2024-04-05","2025-10-03","2025-10-07","2025-10-07","2023-10-24","2023-10-24","2023-10-24","2023-10-24","2024-08-16","2025-06-19","2024-10-24","2025-06-28","2025-10-30","2024-10-24","2025-06-28","2024-11-21","2024-03-15","2025-09-11","2025-06-19","2024-03-19","2024-03-19","2024-12-23","2025-10-06","2024-04-05","2025-09-11","2023-09-06","2025-08-29","2025-08-29","2025-08-29","2025-11-06","2025-11-06","2024-09-30","2024-09-30","2024-09-30","2025-10-11","2025-10-11","2025-10-11","2024-09-11","2025-06-16","2023-11-28","2023-07-31","2025-06-19","2022-12-01","2022-12-01","2024-11-05","2022-10-22","2022-10-16","2022-10-19","2022-10-19","2022-10-19","2022-09-20","2022-09-20","2022-08-22","2022-09-02","2022-09-02","2022-08-11","2022-08-11","2022-05-16","2022-02-28","2022-02-28","2022-02-14","2022-02-14","2022-02-14"],"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":[["","","PROPRANOLOL HCL ER","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","NEOMYCIN-BACITRACIN-POLY-HC","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","NADOLOL","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","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":""}]}]}