{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kathy E Watters","gend":1,"currentgend":"","add":"406 BOWERBANK RD","city":"DOVER FOXCROFT","state":"ME","zip":"04426","dob":"1957-04-08","age":"","mstatus":"","insh":"10000095952","cliId":"","pno":2075642817,"cno":"","email":"kwatters406@gmail.com","ename":"","eno":"","pphy":"ROXAS, SHARON K","ppno":2079073777,"pcpadd":"EMMC Family Medicine of Brewer,234 State St","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"406 BOWERBANK RD","madd2":"","madd3":"","mcity":"DOVER FOXCROFT","mstate":"ME","mzip":"04426","pcpfaxno":2079073778,"pcpnpi":1912211483,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8RV2R47YR80","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["D485","M9903","G479","L2089","Z1211","L814","D225","L821","M5442","L986","M810","C4401","Z0000","R001","I081","H2511","L309","R0602","H6121","R42","D0371","S7002XA","H2512","M5451","Z0100","S39012A","Z9181","R7989","G4700","S7012XA","W19XXXA","Z1231","R413","Z820","M5136","M47816","J449","Z124","H43811","S0990XA","R9431","I447","R0789","Z23","I493","I491","R791","M79609","W19XXXS","F513","G8929","Z1151","Z01419","G4752","F419","F32A","M79662","E785","M1990","M542","Z13820","G4751","S8992XA","S3993XA","S79922A","S50912A","Z5181","Z7189","M79652"],"date":["2025-07-24","2023-10-05","2025-07-18","2025-07-24","2025-04-17","2025-07-24","2025-07-24","2025-07-24","2023-09-25","2024-03-13","2023-07-14","2024-02-15","2025-08-01","2025-06-17","2025-01-02","2023-11-08","2024-03-13","2025-01-20","2025-06-17","2024-10-10","2025-08-19","2023-08-27","2023-11-01","2023-11-14","2025-08-11","2023-08-29","2023-09-09","2024-10-11","2025-07-18","2023-08-27","2023-08-27","2024-11-29","2025-03-27","2025-03-27","2023-09-09","2023-09-09","2024-11-09","2023-06-08","2024-01-09","2023-08-14","2025-01-20","2025-01-20","2024-11-09","2023-07-21","2024-11-14","2024-11-14","2024-10-11","2023-09-25","2023-09-25","2024-05-02","2023-09-25","2023-06-08","2023-06-08","2024-11-15","2023-07-21","2023-07-21","2023-09-25","2024-06-12","2023-06-08","2023-06-08","2023-07-14","2024-05-02","2023-09-25","2023-09-25","2023-09-25","2023-01-18","2024-08-27","2024-07-24","2023-08-27"],"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":[["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","BETAMETHASONE DIPROP AUGMENTED","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","CLONAZEPAM","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","CLOBETASOL EMOLLIENT","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","LIDOCAINE","","","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":""}]}]}