{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joyce E Duplessie","gend":1,"currentgend":"","add":"126 CUSHMAN RD","city":"WINSLOW","state":"ME","zip":"04901","dob":"1957-12-23","age":"","mstatus":"","insh":"10000104572","cliId":"","pno":2076800442,"cno":"","email":"jduplessie23@hotmail.com","ename":"","eno":"","pphy":"LEBLANC, CHRISTINA","ppno":2078731098,"pcpadd":"MaineGeneral Medical Center,149 North St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"THAYER INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"126 CUSHMAN RD","madd2":"","madd3":"","mcity":"WINSLOW","mstate":"ME","mzip":"04901","pcpfaxno":2078615461,"pcpnpi":1154773935,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4D32GW8VA82","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R059","R0989","R0602","R519","Z1231","F17210","R0600","Z8701","J189","J441","J440","J9601","G43009","M542","M9901","M546","Z122","L814","L821","D2371","Z08","J449","M9902","Z0100","H04123","K259","K317","E792","M25511","E278","K769","R932","K7689","R6889","Z13820","B356","G4733","M25512","L820","L298","L538","R208","J45909","Z01419","Z1151","R062","R590","L570","D225","M19011","M19012","Z1211","Z9981","Z20822","D122","D125","K219","R1310","D123","K621","E279","J989","R918","E049","I7140","J45901","Z79899","M9903","M5451","N200","R1032","R350","H903","H9313","K2950","Z9049","M8589","K635","Z0000","S39012A","I509","X58XXXA","R109","H5203","H52223","H524","Z0101","H2513","F17200","Z579","B9789","J309","K2090"],"date":["2025-04-29","2023-05-19","2023-05-19","2023-05-19","2025-02-18","2025-06-24","2023-07-17","2023-05-08","2023-04-22","2023-03-14","2023-03-13","2023-03-13","2023-08-14","2024-03-25","2024-03-25","2024-03-25","2025-02-28","2025-09-05","2025-09-05","2025-09-05","2024-09-04","2025-11-14","2024-03-25","2023-07-26","2025-03-24","2024-01-16","2024-01-16","2024-01-16","2023-03-24","2024-07-12","2023-11-22","2023-09-13","2023-11-22","2023-11-02","2024-01-09","2024-01-23","2025-11-14","2023-03-24","2024-09-04","2024-09-04","2024-09-04","2024-09-04","2023-07-08","2024-01-23","2024-01-23","2023-07-17","2023-08-08","2025-09-05","2025-09-05","2023-03-17","2023-03-17","2023-10-17","2023-03-13","2023-03-12","2023-10-17","2023-10-17","2023-10-17","2023-10-17","2023-10-17","2023-10-17","2023-09-13","2025-06-01","2023-03-12","2023-03-12","2023-03-12","2025-06-24","2025-06-24","2023-08-16","2023-08-16","2024-07-12","2024-07-12","2024-07-12","2025-03-04","2025-03-04","2023-10-17","2023-11-22","2024-01-09","2023-10-17","2025-01-15","2024-07-12","2023-03-13","2024-07-12","2024-07-12","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-04-29","2025-06-10","2025-06-01","2025-06-10","2024-01-16"],"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":[["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","LOTEPREDNOL ETABONATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","SPIRIVA RESPIMAT","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","INCRUSE ELLIPTA","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":""}]}]}