{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Catherine M Chaisson","gend":1,"currentgend":"","add":"243 BUXTON RD","city":"SACO","state":"ME","zip":"04072","dob":"1958-02-21","age":"","mstatus":"","insh":"10000103981","cliId":"","pno":2072846598,"cno":"","email":"parker3m@maine.rr.com","ename":"","eno":"","pphy":"CHAPPELLE, CATHRA M","ppno":2078282402,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"243 BUXTON RD","madd2":"","madd3":"","mcity":"SACO","mstate":"ME","mzip":"04072","pcpfaxno":2078282425,"pcpnpi":1912957069,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1PG9R88NG19","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":["K760","R7401","R002","Z148","J4540","Z1211","D122","Z1589","K5730","I341","L280","L853","E669","L309","R21","R9389","R0602","I10","E785","R7989","F325","L820","B079","Z1231","M8589","Z780","H40023","H524","E889","I493","E781","Z13228","G43909","I4719","I4720","I498","R109","J479","R233","H9191","H9313","R42","Z006","S0500XA","H40013","Z23","R6889","R911","L821","I781","B353","R9431","Z8249","Z79899","J8410","R918","I340","I3489","I5030"],"date":["2025-03-03","2024-04-11","2025-10-20","2025-06-13","2025-11-03","2025-02-11","2025-02-11","2025-06-13","2025-03-03","2025-10-20","2023-05-11","2023-05-11","2025-05-06","2023-10-17","2025-10-25","2025-06-16","2025-01-02","2025-03-06","2025-10-20","2025-06-13","2024-08-06","2025-02-24","2025-02-24","2025-02-18","2024-02-16","2024-02-16","2025-01-13","2025-01-13","2025-03-03","2025-01-02","2023-05-15","2023-05-15","2024-01-02","2024-11-20","2024-11-20","2024-11-20","2024-02-06","2025-01-03","2023-03-31","2024-12-16","2024-12-16","2024-12-16","2024-12-05","2025-02-03","2025-08-25","2025-10-02","2023-08-21","2024-07-09","2024-02-05","2024-02-05","2024-02-05","2023-12-11","2024-04-29","2024-04-29","2025-01-03","2025-01-03","2025-01-02","2025-01-02","2025-01-02"],"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":[["","","LISINOPRIL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PREVIDENT","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","MOMETASONE FUROATE","","","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":""}]}]}