{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Mary E Jude","gend":1,"currentgend":"","add":"17 HUCKLEBERRY LN","city":"KENNEBUNK","state":"ME","zip":"04043","dob":"1954-02-18","age":"","mstatus":"","insh":"10000105738","cliId":"","pno":2079497878,"cno":"","email":"judeemjay@gmail.com","ename":"","eno":"","pphy":"ATKINSON, CYNTHIA A","ppno":2077745816,"pcpadd":"100 GANNETT DRIVE,SUITE C","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"17 HUCKLEBERRY LN","madd2":"","madd3":"","mcity":"KENNEBUNK","mstate":"ME","mzip":"04043","pcpfaxno":2078741483,"pcpnpi":1487753125,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5RH9G42DA35","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","M1711","M25561","R55","G9589","Z800","Z1509","Z1239","Z803","M1812","M1712","Z471","E7800","H40003","Z0101","Z1231","S0990XA","Z96651","M4802","M47812","Z0001","Z8041","Z1501","M50321","E669","Z13220","R1032","G8918","J45909","I10","I493","M542","N6019","N6489","Z6834","M5431","M5432","R21","R202","D225","L821","L578","Z7183","S46811A","Z124","R001","M21161","M2351","Z23","H16223","K529","R7401","M4312","R748","Z01818","H16143","N8003","M8588","Z1211","K635","K219","H25813","M792","M50323","Z4002","A048","I340","I5030","I517","E785","R4182","R6889","K2970","B9681"],"date":["2025-08-04","2025-10-28","2025-06-02","2025-07-25","2025-10-22","2024-06-11","2024-07-15","2024-09-27","2024-09-27","2025-09-29","2025-09-19","2025-11-11","2025-09-08","2025-07-21","2025-07-21","2025-08-30","2025-07-14","2025-11-11","2025-08-22","2025-10-22","2025-09-08","2024-07-15","2024-10-08","2025-10-22","2023-08-18","2023-05-12","2025-07-14","2025-10-28","2025-10-28","2025-10-28","2025-10-07","2025-10-22","2024-09-27","2025-08-30","2023-08-18","2023-08-18","2023-08-18","2023-08-23","2024-08-21","2024-08-21","2024-08-21","2024-08-21","2024-03-07","2023-02-10","2024-08-09","2025-07-14","2025-06-02","2025-06-02","2024-11-18","2025-01-21","2025-07-14","2025-07-14","2025-10-22","2025-09-08","2025-10-06","2024-12-10","2024-10-21","2025-05-16","2024-11-11","2024-11-11","2024-11-11","2024-01-22","2025-09-30","2023-06-26","2024-10-08","2025-02-25","2025-10-07","2025-10-07","2025-10-07","2024-10-08","2024-10-08","2023-07-11","2024-11-11","2024-11-11"],"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":[["","","PREGABALIN","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","ESTRADIOL","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","LOTEPREDNOL ETABONATE","","","Select","Select",""],["","","XIIDRA","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","TETRACYCLINE HCL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","ESTRING","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","FAMCICLOVIR","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","VALACYCLOVIR","","","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":""}]}]}