{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Donna L Morin","gend":1,"currentgend":"","add":"51 SOMERSET CONDOS","city":"FREEPORT","state":"ME","zip":"04032","dob":"1948-01-14","age":"","mstatus":"","insh":"10000081847","cliId":"","pno":2078650735,"cno":2078695425,"email":"donnamorin72@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":"51 SOMERSET CONDOS","madd2":"","madd3":"","mcity":"FREEPORT","mstate":"ME","mzip":"04032","pcpfaxno":2075238586,"pcpnpi":1164868964,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9YV4AR1WT99","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R911","R918","I2510","Z03818","E1159","I10","E782","Z794","S42292A","R002","E7800","S42202D","Z860101","Z1211","R748","J129","Z538","K5730","S43015A","E042","Z8616","B353","B351","M79674","M79675","Z0001","G5601","R9389","E1165","E785","E669","Z0000","E1169","E1129","Z23","M19012","S42135A","L852","R262","R251","R0781","M8580","R5383","M7910","Z1231","S43005A","R112","R197","R1032","R350","Z20822","E1142","H9313","J069","H9012","H9312","R300","Z0101","H524","E119","H2513","E118","N3010","S43085A","R0789","K660","K8020","N281","K429","R109","Z87898","S4981XA","S0990XA","R9089","S199XXA","M47812","Z043","M85812","R3915","Z136","I420","I3481","R52","Z1159","R590","R928","R921","R922","U071","J029","R531","J159","R079","J984","R509","E041","R519","R059","J1282"],"date":["2025-08-15","2025-08-15","2025-08-15","2023-12-21","2025-11-17","2025-11-17","2025-11-17","2025-11-17","2025-01-26","2025-08-01","2023-03-16","2025-02-03","2024-11-01","2025-10-06","2023-03-21","2024-08-01","2024-11-01","2024-11-01","2025-03-26","2024-01-30","2024-08-01","2024-06-18","2025-11-05","2025-11-05","2025-11-05","2025-03-31","2025-02-19","2025-08-15","2024-11-25","2025-03-31","2024-11-01","2024-03-29","2025-03-31","2023-03-21","2025-09-22","2025-02-19","2025-02-19","2025-11-05","2025-11-05","2025-01-10","2023-05-08","2025-03-31","2024-03-22","2024-03-22","2024-11-15","2025-01-26","2024-11-25","2024-11-18","2023-12-21","2023-12-21","2023-12-21","2025-07-30","2024-06-06","2022-12-15","2023-05-02","2023-05-02","2022-12-15","2025-05-29","2023-02-02","2025-05-29","2025-05-29","2023-01-19","2025-02-24","2025-01-26","2025-04-11","2024-11-18","2024-11-18","2024-11-18","2024-11-18","2024-11-18","2024-11-18","2025-01-26","2025-01-26","2025-01-26","2025-01-26","2025-01-26","2025-01-27","2025-01-27","2022-10-26","2022-10-26","2022-11-14","2022-11-14","2022-09-30","2022-09-22","2022-05-11","2022-05-11","2022-05-11","2022-05-11","2022-01-13","2021-12-30","2022-01-02","2022-01-11","2022-01-11","2022-01-11","2022-01-01","2022-01-13","2022-01-13","2022-01-01","2022-01-13"],"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":[["","","TRESIBA FLEXTOUCH U-200","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ONETOUCH ULTRA2","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 READER","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","CAREFINE PEN NEEDLE","","","Select","Select",""],["","","UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","ULTRA-FINE NANO PEN NEEDLE","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}