{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Julie M Floerchinger","gend":1,"currentgend":"","add":"70 MOODY RD","city":"LIMINGTON","state":"ME","zip":"04049","dob":"1956-07-21","age":"","mstatus":"","insh":"10000086461","cliId":"","pno":2079290085,"cno":"","email":"ddw36593@gmail.com","ename":"","eno":"","pphy":"PELLETIER, ASHLEY L","ppno":"","pcpadd":"70 MAIN ST,","pcpcity":"PORTER","pcpstate":"ME","pcpzip":"40683527","pcpcounty":"","pcpid":"","pcpname":"SACOPEE VALLEY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"70 MOODY RD","madd2":"","madd3":"","mcity":"LIMINGTON","mstate":"ME","mzip":"04049","pcpfaxno":"","pcpnpi":1902321102,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5ND6G94YV47","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":["R609","R079","I83812","F418","Z720","I83813","E669","E88819","R102","R140","M1711","M25561","E559","M810","M23306","Z1231","L821","N952","N9419","I8390","R600","Z0000","Z1211","Z0100","H2513","H04123","Z124","M9913","M62830","M9902","M9901"],"date":["2023-10-04","2023-10-24","2023-02-17","2023-01-20","2023-01-20","2023-05-23","2024-02-01","2024-02-02","2023-11-16","2023-11-16","2023-07-11","2023-04-17","2025-03-20","2025-04-01","2023-07-11","2024-12-20","2023-05-15","2023-03-29","2023-03-29","2024-12-20","2023-09-05","2022-12-14","2023-01-23","2025-01-30","2025-01-30","2025-01-30","2023-03-29","2022-11-10","2022-11-10","2022-11-10","2022-11-10"],"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":[["","","BUMETANIDE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ESTRADIOL","","","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":""}]}]}