{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Noreen Doughty","gend":1,"currentgend":"","add":"28 LUPINE CIR","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1957-01-16","age":"","mstatus":"","insh":"10000094505","cliId":"","pno":2078372065,"cno":"","email":"Noreen.doughty@gmail.com","ename":"","eno":"","pphy":"TRAPP, KATHLEEN R","ppno":2077984400,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"28 LUPINE CIR","madd2":"","madd3":"","mcity":"BRUNSWICK","mstate":"ME","mzip":"04011","pcpfaxno":2078287850,"pcpnpi":1386603397,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2VM3M07DP89","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D3002","E7800","I5022","I255","I080","I5040","I2510","I25110","Z859","N2889","K8010","K8020","J45909","I509","Z13220","Z79899","I083","I447","I950","I420","C50911","Z1231","I517","I25111","Z5320","J0190","R053","J4520","Z136","I501","I5030","R6889","D369","R945","R0609","Z853","Z9221","Z7689","M810","C50919","I5023","N281","R059","Z0101","R9439","K819","R9431","R931","K828","N289","R112","R1011","Z780","R109"],"date":["2023-11-02","2025-06-23","2025-10-06","2024-03-29","2023-08-14","2023-08-14","2025-01-07","2023-04-19","2023-09-26","2023-11-03","2023-03-22","2023-03-22","2023-11-02","2023-03-22","2024-09-30","2023-02-06","2025-06-10","2025-06-10","2024-10-25","2023-08-17","2023-08-17","2025-01-06","2023-11-06","2023-04-21","2024-10-14","2023-01-27","2023-01-27","2023-01-27","2023-02-06","2024-03-29","2025-06-10","2023-05-11","2024-05-10","2023-03-22","2023-04-21","2023-01-17","2023-01-17","2023-01-17","2024-12-03","2023-03-02","2023-02-28","2023-09-19","2023-01-27","2024-12-06","2023-04-06","2023-04-06","2023-02-27","2023-02-27","2023-02-20","2023-02-20","2023-02-20","2023-02-20","2024-11-29","2023-02-21"],"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":[["","","ENTRESTO","","","Select","Select",""],["","","SACUBITRIL-VALSARTAN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}