{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Candace L Manocchio","gend":1,"currentgend":"","add":"310 CUSHNOC RD","city":"VASSALBORO","state":"ME","zip":"04989","dob":"1946-11-13","age":"","mstatus":"","insh":"10000083800","cliId":"","pno":2076221046,"cno":2072426821,"email":"cmanocchio@roadrunner.com","ename":"","eno":"","pphy":"THOMAS, RACHEL","ppno":2076218800,"pcpadd":"Augusta Family Medicine,15 Enterprise Dr","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"AUGUSTA FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"310 CUSHNOC RD","madd2":"","madd3":"","mcity":"VASSALBORO","mstate":"ME","mzip":"04989","pcpfaxno":2076261849,"pcpnpi":1013576404,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4U19JQ2VQ32","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L570","N950","L602","I771","M8589","Z780","L218","D225","L814","L821","D485","Z4789","I358","N840","R0789","E785","D259","N888","N939","L84","R6889","L719","N904","L918","L538","Z01818","M25511","M7741","M7742","Z98890","C44729","L603","R011","R9431","E7800","D229","L578","I781","L905","I083","N898","L989","R2242","L728","L2089","Z124","Z9189","Z0000","I70203","R87610","Z471","B351","L851","Z1231","L988","M75101","Z5333","L259","M75121","G8918","M19011","M25811"],"date":["2025-11-12","2023-12-14","2023-08-23","2023-05-24","2023-12-29","2023-12-29","2025-05-14","2025-05-14","2025-05-14","2025-05-14","2025-05-14","2023-04-19","2023-06-28","2023-12-14","2023-10-24","2023-06-28","2023-11-02","2023-11-02","2023-11-02","2024-11-07","2023-07-01","2025-09-23","2024-10-30","2023-04-20","2023-04-20","2023-12-07","2023-02-08","2023-11-29","2023-11-29","2023-04-19","2025-06-12","2022-12-19","2023-07-20","2023-07-20","2023-07-20","2023-10-06","2023-10-06","2023-10-06","2025-06-12","2023-07-26","2024-10-30","2024-06-27","2024-06-27","2023-10-06","2024-09-24","2023-10-11","2023-10-11","2025-05-28","2023-05-18","2023-10-11","2023-01-04","2023-04-26","2023-04-26","2023-07-10","2023-11-22","2022-09-27","2022-09-27","2022-09-12","2022-09-27","2022-09-27","2022-09-27","2022-09-27"],"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":[["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","BETAMETHASONE DIPROP AUGMENTED","","","Select","Select",""],["","","NORETHINDRONE ACETATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","PREVNAR 20","","","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":""}]}]}