{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Amanda E Hutchinson","gend":1,"currentgend":"","add":"13 TOWNHOUSE DR","city":"SOUTH PORTLAND","state":"ME","zip":"04106","dob":"1982-10-26","age":"","mstatus":"","insh":"10000104174","cliId":"","pno":2075725744,"cno":"","email":"tylersmommy1214@gmail.com","ename":"","eno":"","pphy":"HOFFMAN, SARA M","ppno":2077998596,"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":"13 TOWNHOUSE DR","madd2":"","madd3":"","mcity":"SOUTH PORTLAND","mstate":"ME","mzip":"04106","pcpfaxno":2078287850,"pcpnpi":1073586491,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2UC2CN8PJ27","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":["F603","M5416","M2569","M6281","R293","F1120","K2971","F341","M9908","M9900","M9901","M9902","Z1231","M9903","M5442","M9905","M62830","F900","Z0100","D509","G2581","R5383","Z5309","R042","F4310","Z8719","Z87891","Z79899","M9907","F411","K432","F410","K319","K2970","K219","K449","R4182","D649","F32A","Z09","E66812","E88819","Z6839","E6601","R10811","R778","F1910","K429","E785","K439","Z23","F902","F1121","I10","Z0189","Z13220","Z0184","Z124","N898","R109","R945","K5900","Z1159"],"date":["2025-10-08","2024-07-24","2024-07-24","2024-07-24","2024-07-24","2025-10-25","2025-06-14","2025-07-02","2024-06-07","2025-03-17","2025-03-17","2025-03-17","2024-06-10","2024-03-08","2024-03-08","2024-03-08","2024-03-08","2025-07-30","2024-05-28","2025-09-26","2024-03-08","2025-03-24","2024-11-19","2025-06-14","2025-11-13","2025-06-14","2025-06-14","2025-06-14","2025-03-17","2025-07-02","2024-10-23","2024-12-11","2024-11-19","2024-11-19","2024-11-19","2024-11-19","2024-11-19","2024-10-23","2024-10-23","2024-11-04","2025-10-27","2024-11-29","2025-10-27","2025-10-27","2024-07-24","2024-08-15","2025-03-24","2024-07-18","2024-07-18","2024-07-18","2025-01-09","2025-02-26","2025-02-26","2025-08-18","2025-08-18","2025-08-18","2025-08-18","2024-02-05","2024-02-05","2024-03-03","2024-02-29","2024-03-03","2024-02-29"],"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":[["","","CLONIDINE HCL","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","BUPROPION HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","VYVANSE","","","Select","Select",""],["","","LINZESS","","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","PRAZOSIN HCL","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","AIMOVIG AUTOINJECTOR","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","OXYCODONE 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":""}]}]}