{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robin M Riendeau","gend":0,"currentgend":"","add":"24 FAIRVIEW DR","city":"SANFORD","state":"ME","zip":"04073","dob":"1957-08-13","age":"","mstatus":"","insh":"10000098736","cliId":"","pno":6172855784,"cno":"","email":"","ename":"","eno":"","pphy":"MEADOWS, RHIANNA M","ppno":"","pcpadd":"840 E MCKELLIPS RD,SUITE 101","pcpcity":"MESA","pcpstate":"AZ","pcpzip":"85203964","pcpcounty":"","pcpid":"","pcpname":"NASSON OFFSITE CLINICAL CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"24 FAIRVIEW DR","madd2":"","madd3":"","mcity":"SANFORD","mstate":"ME","mzip":"04073","pcpfaxno":4808338313,"pcpnpi":1194988311,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7VR2X64GN82","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M5450","G4733","R0683","R300","E785","M2560","R531","H1031","M5459","R293","Z125","I10","Z1211","Z86010","K635","K5730","D225","R6889","L570","D492","N400","H903","J342","R059","D122","D132","D124","K449","K2270","K317","K219","Z2989","S70361A","M170","A6920","F988","M25561","L814","L578","M5117","R12","J069","K2100","J40","W57XXXA"],"date":["2023-09-21","2025-09-18","2023-09-19","2025-08-13","2025-08-28","2023-09-21","2024-09-18","2024-05-12","2024-09-18","2024-09-18","2025-08-28","2025-08-28","2023-11-27","2023-11-27","2023-11-27","2023-11-27","2025-09-15","2023-01-01","2025-09-15","2025-09-15","2025-10-01","2025-11-11","2024-11-05","2023-01-04","2023-11-27","2023-11-27","2023-11-27","2023-11-27","2023-11-27","2023-11-27","2023-11-01","2025-07-13","2025-07-15","2025-09-09","2025-07-18","2024-08-12","2025-09-09","2025-02-12","2025-02-12","2023-09-18","2023-11-01","2025-11-03","2023-11-27","2025-11-03","2025-07-15"],"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":[["","","DICLOFENAC POTASSIUM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","TOBRAMYCIN","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","ATOMOXETINE HCL","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":""}]}]}