{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lyta G Seddig","gend":1,"currentgend":"","add":"7 HIGH RD","city":"SOUTHWEST HARBOR","state":"ME","zip":"04679","dob":"1944-02-22","age":"","mstatus":"","insh":"10000091105","cliId":"","pno":2072447887,"cno":2076102456,"email":"holylisteningmdi@gmail.com","ename":"","eno":"","pphy":"HANKE, TANYA","ppno":2072445630,"pcpadd":"10 WAYMAN LN,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46091625","pcpcounty":"","pcpid":"","pcpname":"MDI COMMUNITY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"15 EAST MARSHALL AVE","madd2":"","madd3":"","mcity":"PHOENIX","mstate":"AZ","mzip":"85012","pcpfaxno":"","pcpnpi":1760644082,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4MX6AP8PP58","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T3120","T300","T794XXA","S2241XA","M25562","M0609","R419","T2121XA","K449","J90","R152","R151","N8184","I10","Z4682","J984","B351","H2512","R933","I080","R918","M8589","H40053","M79672","M79671","L602","J9811","R0902","M21622","M7742","D3131","M25561","M069","M7752","H26491","R600","Q828","I878","M0579","Z01818","H353132","Z79899","H2513","H353122","N3944","H527","H524","D849","K259","K2289","G252","Z5181","S299XXA","M06041","R3915","E46","R4182","M8580","R2689","E0590","J982","H2511","I499","N3289","Z452","J811","E031","Z1231","D649","M8588","R001","Z515","Z7189","M1611","W19XXXA","S3991XA","S3993XA","H25093","M47816","Z1211","I952","T310","Z9989","R42","E039","M79642","Z0000","K5900","R109","T2029XA","M5450","S0990XA","S199XXA","Z4659","R410","Z9911","L89893","N3941","H903","M8000XA","M06042","B029"],"date":["2025-08-29","2025-08-30","2025-08-14","2025-08-29","2024-03-14","2024-05-06","2025-06-04","2025-08-14","2025-08-29","2025-08-25","2022-12-28","2022-12-28","2022-12-28","2025-08-22","2025-08-27","2025-08-23","2024-10-14","2024-09-30","2025-08-15","2025-08-22","2025-08-26","2025-04-28","2024-11-13","2024-06-03","2024-06-03","2024-06-03","2025-08-20","2025-08-27","2025-07-14","2025-07-14","2025-07-02","2024-05-01","2024-10-11","2022-11-21","2025-08-06","2025-04-02","2024-10-14","2024-10-14","2025-05-23","2025-08-22","2025-07-02","2025-05-23","2024-08-14","2023-04-13","2025-04-21","2024-11-13","2024-11-13","2024-05-10","2025-08-19","2025-08-19","2025-04-02","2025-05-23","2025-08-14","2023-06-29","2022-10-14","2025-08-16","2025-08-19","2024-04-15","2024-04-15","2024-04-15","2025-08-30","2024-10-21","2025-08-21","2025-08-31","2025-08-29","2025-08-28","2024-05-21","2023-06-27","2025-08-29","2024-03-18","2025-02-19","2025-08-30","2025-08-30","2025-08-14","2025-08-14","2025-08-14","2025-08-14","2022-10-06","2023-09-12","2022-10-26","2025-04-28","2025-08-14","2025-08-14","2025-08-14","2024-01-09","2024-03-14","2024-06-06","2024-03-21","2024-03-21","2025-08-14","2023-09-12","2025-08-14","2025-08-14","2025-08-16","2025-08-21","2025-08-22","2023-08-28","2022-09-13","2022-09-27","2022-08-19","2022-08-19","2022-08-26"],"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":[["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ARMOUR THYROID","","","Select","Select",""],["","","HYDROXYCHLOROQUINE SULFATE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","LEFLUNOMIDE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","OLMESARTAN MEDOXOMIL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","VALACYCLOVIR","","","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":""}]}]}