{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Judy M Knowlton","gend":1,"currentgend":"","add":"421 JUNIPER LN SO","city":"Sidney","state":"ME","zip":"04330","dob":"1956-05-15","age":"","mstatus":"","insh":"10000085820","cliId":"","pno":2075477072,"cno":"","email":"judyknowlton@hotmail.com","ename":"","eno":"","pphy":"CARON, LAURA P","ppno":2072136713,"pcpadd":"Family Focused Healthcare,219 Capitol St Ste 5","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"FAMILY FOCUSED HEALTHCARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"421 JUNIPER LN SO","madd2":"","madd3":"","mcity":"Sidney","mstate":"ME","mzip":"04330","pcpfaxno":2072136785,"pcpnpi":1528034303,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2XR5QP6UF96","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z7189","R1900","Z85038","R150","K6289","K6030","Z8719","C44310","M25562","E785","K611","Z0000","C181","E6601","F419","K5900","K219","G3184","L821","K624","K644","D373","Z1211","K635","K649","Z1231","K760","K645","K603","Z0101","H40013","H04123","K601","K641","C786","K643","K642","L290","L0291","R350","R6889","K7689","N281","Z9049","D490","R935","D120","D125","K6389","Z86010","M8588","Z780","H9191","Z13820","R42"],"date":["2025-09-12","2025-06-01","2025-06-01","2023-12-13","2025-10-09","2025-10-09","2025-10-09","2023-09-05","2023-09-05","2023-09-05","2023-09-05","2023-09-05","2025-01-28","2024-01-31","2023-09-05","2023-09-05","2023-09-05","2023-09-05","2024-01-31","2024-01-31","2023-10-18","2025-06-10","2023-09-27","2023-09-27","2023-01-06","2025-11-14","2024-05-14","2023-01-06","2023-01-06","2025-08-18","2025-08-18","2025-08-18","2023-10-18","2023-10-18","2023-03-14","2023-07-26","2023-08-14","2023-08-14","2023-08-14","2025-04-28","2023-07-10","2023-01-30","2023-01-30","2023-01-30","2023-01-30","2023-03-08","2023-09-27","2023-09-27","2023-09-27","2023-09-27","2022-09-22","2022-09-22","2022-09-20","2022-09-22","2022-09-20"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","BUPROPION HCL SR","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","KLAYESTA","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","LIDOCAINE","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","NYSTOP","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","PNEUMOVAX 23","","","Select","Select",""],["","","PFIZER COVID (12Y UP) VAC(EUA)","","","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":""}]}]}