{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Elizabeth Fitzgerald","gend":1,"currentgend":"","add":"95 SMALLS POINT RD","city":"MACHIASPORT","state":"ME","zip":"04655","dob":"1949-04-21","age":"","mstatus":"","insh":"10000101655","cliId":"","pno":2072635439,"cno":"","email":"bfitz177@rocketmail.com","ename":"","eno":"","pphy":"HARTMAN, ALBERT F","ppno":"","pcpadd":"Down East Community Hospital Medical Associates,11 Hospital Dr","pcpcity":"Machias","pcpstate":"ME","pcpzip":"04654","pcpcounty":"","pcpid":"","pcpname":"MACHIAS FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"95 SMALLS POINT RD","madd2":"","madd3":"","mcity":"MACHIASPORT","mstate":"ME","mzip":"04655","pcpfaxno":"","pcpnpi":1790110237,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4NN0P75FN00","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M5450","M25551","M25552","I10","E7800","D472","M5417","Z471","M1611","Z96653","Z1231","Z780","Z0000","Z0100","N3000","R1030","K5900","Z96641","M160","R109","Z1211","D123","K621","K635","Z86010","Z01818","M25751","M5136"],"date":["2025-06-24","2025-06-24","2025-06-24","2025-04-16","2024-12-19","2025-08-18","2025-01-02","2025-03-27","2024-09-23","2025-03-27","2025-03-05","2025-01-28","2024-12-19","2025-05-05","2025-06-04","2025-06-04","2023-01-25","2025-03-27","2024-08-08","2023-01-25","2023-11-28","2023-11-28","2023-11-28","2023-11-28","2023-11-28","2024-07-23","2024-08-08","2023-01-05"],"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":[["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","LISINOPRIL-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","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":""}]}]}