{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Julienne D Ewing","gend":1,"currentgend":"","add":"48 WASHINGTON ST","city":"BREWER","state":"ME","zip":"04412","dob":"1953-04-15","age":"","mstatus":"","insh":"10000099602","cliId":"","pno":2078525881,"cno":"","email":"Memajewing@gmail.com","ename":"","eno":"","pphy":"PARADIS, KENDRA M","ppno":"","pcpadd":"C\/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT,PO BOX 7291","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"48 WASHINGTON ST","madd2":"","madd3":"","mcity":"BREWER","mstate":"ME","mzip":"04412","pcpfaxno":2077774397,"pcpnpi":1588012314,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5VX8K95JJ64","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":["M5416","M6281","M5451","M5417","M479","J0100","J209","M9901","M542","M9903","M5450","L570","L814","D225","L821","L813","J439","J929","R059","F902","F411","M810","J0190","M5442","R0602","J3089","J329","J45901","R413","N179","F410","F5081","T783XXA","Z0000","F4322","K529","H5789","M5137","M47817","F331","R079","R8290","H26491","M19011","Z0101","J4521","R6889","Z23","Z1211","K047","M5441","G8929","M7910","M9904","H1031","Z1231","R0781","R051","Z20822","K635","S70361A","F329","F1011","Z818","S299XXA","J029","R0981","E871","F419","F32A","J984","N281","R5383","H26493","Z860100","D122","K640","R0789","F0390","J3489","M25561","M25562","M4727","R519","Z86006","D485","M269","M5116","M4726","J4520","K6389","Z780","J069","B974","M519","M170","H903"],"date":["2024-09-09","2024-09-09","2024-03-28","2024-03-28","2024-03-28","2025-06-02","2025-06-02","2024-07-01","2024-07-01","2024-07-01","2024-07-01","2023-10-13","2025-02-18","2025-02-18","2025-02-18","2025-02-18","2024-12-29","2024-12-29","2024-12-29","2025-07-16","2023-08-30","2024-12-19","2024-03-26","2024-02-20","2023-08-12","2023-08-28","2024-07-06","2025-11-02","2023-08-12","2023-01-24","2024-12-09","2023-05-25","2023-08-28","2024-09-18","2024-03-11","2023-06-21","2023-07-17","2024-02-12","2024-02-12","2025-03-31","2024-12-30","2023-06-21","2023-03-21","2024-03-18","2025-11-13","2025-01-13","2023-04-13","2025-01-13","2024-11-15","2024-08-19","2024-02-12","2024-02-12","2023-02-02","2023-02-02","2025-03-04","2024-09-18","2023-10-16","2023-11-09","2023-12-12","2024-11-15","2023-07-14","2023-08-30","2023-08-30","2023-03-31","2023-10-16","2023-01-05","2023-01-05","2023-06-17","2023-06-17","2023-06-17","2023-11-09","2024-06-07","2023-01-12","2023-03-16","2024-11-15","2024-11-15","2024-11-15","2023-08-12","2023-08-12","2024-07-23","2025-03-31","2025-03-31","2024-04-03","2024-07-06","2023-10-13","2025-11-18","2024-07-06","2024-02-20","2024-02-20","2023-03-24","2024-11-15","2024-06-10","2022-11-16","2022-11-16","2022-11-25","2022-11-25","2022-10-14"],"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":[["","","SERTRALINE HCL","","","Select","Select",""],["","","BUPROPION HCL","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","AIRSUPRA","","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","PROMETHAZINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHET ER","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","ACETAMINOPHEN-CODEINE","","","Select","Select",""],["","","ATOMOXETINE HCL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","FLUCELVAX QUAD 2023-2024","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","FLUTICASONE PROPIONATE HFA","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLOVENT HFA","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","PAXLOVID (EUA)","","","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":""}]}]}