{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joyce M Funaro","gend":1,"currentgend":"","add":"869 RIVER RD","city":"Richmond","state":"ME","zip":"04357","dob":"1960-02-13","age":"","mstatus":"","insh":"10000088609","cliId":"","pno":7175921469,"cno":"","email":"joycefunaro1@gmail.com","ename":"","eno":"","pphy":"GARDINER, PAMELA A","ppno":2077984050,"pcpadd":"Martins Point Healthcare,74 Baribeau Dr","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"869 RIVER RD","madd2":"","madd3":"","mcity":"Richmond","mstate":"ME","mzip":"04357","pcpfaxno":2078287850,"pcpnpi":1023030020,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9HU9JK9JH59","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":["F322","M546","M6281","Z931","I421","Z434","E7801","Z431","K3184","E213","M7918","I081","R0600","Z1231","M839","M810","E559","K635","Z1211","I471","Q208","I10","R0609","M4850XA","R9341","R112","Z9049","Z9089","K529","R109","Z934","F32A","Z780","I422","G44019","Z1159","E785","E039","G43709","E782","L218","R011","Z9682","K9413","T85848A","D123","K219","G8929","I4710","Z23","I77810","M8008XA","E860","R748","R944","Z4682","Z7689"],"date":["2025-10-27","2023-09-20","2023-09-20","2025-09-06","2025-08-22","2025-09-26","2025-07-09","2023-07-21","2025-09-06","2024-06-03","2023-05-11","2024-09-18","2024-09-18","2025-08-01","2025-10-09","2025-07-20","2025-06-06","2023-10-06","2023-10-06","2023-09-19","2024-02-01","2025-08-05","2023-09-19","2025-10-09","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2023-05-18","2025-06-20","2023-11-06","2023-05-01","2025-07-17","2024-05-30","2024-12-31","2024-06-03","2025-06-06","2025-06-06","2024-10-21","2024-05-30","2025-05-29","2023-06-27","2023-05-11","2023-11-22","2023-11-22","2023-10-06","2023-10-06","2025-06-20","2025-08-22","2025-06-10","2023-06-27","2022-10-27","2022-11-02","2022-11-02","2022-11-02","2022-11-02","2022-09-26"],"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","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","EMGALITY SYRINGE","","","Select","Select",""],["","","VENLAFAXINE HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","FLUOCINONIDE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","REPATHA SURECLICK","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","ZOLMITRIPTAN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PRALUENT PEN","","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["","","LORAZEPAM","","","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":""}]}]}