{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Marie R Aikins","gend":1,"currentgend":"","add":"28 TURKEY TRL","city":"Windham","state":"ME","zip":"04062","dob":"1956-12-28","age":"","mstatus":"","insh":"10000092853","cliId":"","pno":2072320057,"cno":"","email":"willow591@gmail.com","ename":"","eno":"","pphy":"ATKINSON, CYNTHIA A","ppno":2077745816,"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":"28 TURKEY TRL","madd2":"","madd3":"","mcity":"Windham","mstate":"ME","mzip":"04062","pcpfaxno":2078741483,"pcpnpi":1487753125,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7KU5TR6PQ75","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":["G4737","C50912","N6481","R0789","I10","M7989","R059","D0512","G4733","E66811","M810","R519","Z170","D381","R531","M069","M150","Z79899","F951","R419","R0600","Z0000","R0609","R053","M25511","R112","L408","L821","L910","D225","E88819","E669","M25552","J383","R21","U099","R5383","R0602","D3A090","Z79811","G629","K589","M4316","M47816","K219","J45909","R921","F5112","N6011","N6489","K5641","M19072","F09","E8881","Z6827","R6889","U071","R918","Z6831","C7A090","R7989","Z0001","L282","L308","Z6833","Z713","L989"],"date":["2025-06-03","2023-02-06","2023-01-18","2025-01-06","2025-01-06","2025-02-05","2025-04-16","2025-06-09","2025-09-10","2025-09-10","2025-06-09","2025-06-09","2025-06-09","2023-06-08","2023-05-18","2025-10-22","2025-10-22","2025-10-22","2025-08-07","2022-12-14","2024-11-06","2024-05-29","2024-08-21","2025-04-14","2024-06-11","2025-04-11","2024-01-04","2024-01-04","2024-01-04","2024-01-04","2025-09-10","2024-08-14","2025-01-29","2025-07-02","2022-12-21","2022-12-21","2022-12-21","2025-04-16","2023-01-03","2024-10-07","2025-10-14","2023-02-06","2025-10-14","2025-10-14","2023-01-25","2023-01-25","2022-12-16","2024-06-03","2023-02-06","2023-02-06","2025-02-05","2022-11-18","2022-10-24","2022-11-09","2022-07-20","2022-06-29","2022-06-29","2022-05-17","2022-05-20","2022-05-20","2022-05-20","2022-05-20","2022-05-04","2022-03-28","2022-03-16","2022-02-10","2022-01-12"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","NALTREXONE HCL","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ROPINIROLE ER","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ROPINIROLE HCL","","","Select","Select",""],["","","PERMETHRIN","","","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":""}]}]}