{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Debra J Thorne","gend":1,"currentgend":"","add":"10 PAPAS WAY","city":"AUGUSTA","state":"ME","zip":"04330","dob":"1956-12-22","age":"","mstatus":"","insh":"10000097788","cliId":"","pno":2074857526,"cno":"","email":"racin2017@yahoo.com","ename":"","eno":"","pphy":"PHELPS, JULIE J","ppno":"","pcpadd":"Waterville Family Practice,31 Front St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"WATERVILLE FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"10 PAPAS WAY","madd2":"","madd3":"","mcity":"AUGUSTA","mstate":"ME","mzip":"04330","pcpfaxno":2078731186,"pcpnpi":1679562979,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7G09UG2VM47","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z1231","K5900","Z1211","D122","Z90710","M810","Z780","N816","E785","Z79899","Z0000","Z1331","Z139","Z23","K621","Z860101","R5383","E119","R631","Z1389","E559","R531","I10","R519","G8929","R109","K6289","N951","F32A","N898","J4520","F3341","K219","R92323","S61219A","S61200A","W278XXA"],"date":["2025-09-05","2023-10-29","2025-01-28","2025-01-28","2023-10-29","2024-05-08","2024-03-20","2023-03-02","2025-09-25","2024-02-02","2025-04-15","2025-04-15","2025-04-15","2024-02-09","2025-01-28","2025-01-28","2025-01-07","2025-09-25","2025-01-07","2025-04-15","2025-01-07","2025-01-07","2025-09-25","2025-07-17","2025-07-17","2023-10-29","2025-01-28","2022-12-23","2022-12-23","2025-07-17","2025-09-25","2025-02-13","2025-02-13","2025-09-05","2025-02-27","2025-02-23","2025-02-23"],"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":[["","","OZEMPIC","","","Select","Select",""],["","","FREESTYLE LIBRE 2 PLUS SENSOR","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","FREESTYLE LIBRE 2 SENSOR","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","MYRBETRIQ","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUARIX QUAD 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}