{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Melanie Mason","gend":1,"currentgend":"","add":"20 RUNNING TIDE DR","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1951-11-01","age":"","mstatus":"","insh":"10000091701","cliId":"","pno":2078072150,"cno":"","email":"tango66.mm@gmail.com","ename":"","eno":"","pphy":"HOWE, ALLYSON S","ppno":2077811500,"pcpadd":"100 GANNETT DRIVE,SUITE C","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"20 RUNNING TIDE DR","madd2":"","madd3":"","mcity":"SCARBOROUGH","mstate":"ME","mzip":"04074","pcpfaxno":2078741483,"pcpnpi":1679662563,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8RC9CD3VM38","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z510","C7801","Z85831","R000","C480","M47812","Z8673","F32A","Z5111","M25551","M5450","Z01818","R1900","Z483","Z452","R6889","I6523","I4891","Z1231","C499","M5137","M47817","R4701","R911","Z23","Z9221","M5114","M4724","M810","M1611","R188","Z905","F4323","C3431","S0012XA","R918","G8918","R109","M6281","R293","R471","I498","I083","I499","R0902","M4726","M542","C494","R112","T451X5A","Z0100","E861","R530","R509","M71551","Z87891","R1031","M160","R1084","R42","I4729","I493","K689","Z48813","Z01810","R29818","Z4682","F3340","G893","I484","D2362","D485","L308","L853","L578","Z0000","R7303","Z0001","M8580","Z86010","L720","F329","L989","F418","Z658"],"date":["2025-09-29","2025-09-29","2025-09-29","2023-03-18","2025-10-24","2023-03-03","2023-03-03","2023-03-03","2025-06-06","2025-11-17","2024-11-20","2025-07-08","2025-07-08","2025-10-03","2025-03-26","2023-06-17","2023-01-27","2025-03-31","2025-01-07","2025-09-11","2024-02-13","2024-02-13","2023-02-06","2025-06-30","2023-05-05","2025-08-19","2024-02-13","2024-02-13","2023-05-05","2024-12-31","2025-08-26","2025-08-20","2023-03-24","2025-03-12","2023-10-26","2025-05-13","2025-08-25","2025-08-25","2025-11-17","2025-11-17","2023-02-07","2025-03-31","2025-03-21","2025-03-21","2025-08-19","2024-05-31","2024-05-31","2025-08-19","2025-05-16","2025-05-16","2023-03-27","2025-04-30","2025-04-30","2025-08-24","2024-12-31","2025-09-16","2025-08-26","2024-08-09","2025-01-09","2023-02-06","2023-04-11","2023-04-11","2025-02-04","2025-03-12","2025-07-29","2023-04-14","2025-08-20","2025-04-04","2025-04-04","2025-02-27","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-10-12","2022-09-02","2022-09-02","2022-09-02","2022-09-02","2022-07-25","2022-04-26","2021-12-16","2022-02-10","2022-02-10","2022-02-10"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","LIDOCAINE-PRILOCAINE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","IBANDRONATE SODIUM","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","TENIVAC","","","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":""}]}]}