{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cynthia T Lebel","gend":1,"currentgend":"","add":"6 LANDING RD","city":"SACO","state":"ME","zip":"04072","dob":"1958-04-27","age":"","mstatus":"","insh":"10000105843","cliId":"","pno":2076503545,"cno":"","email":"ctlebel@gmail.com","ename":"","eno":"","pphy":"BUEHNER, MORGEN M","ppno":2078741489,"pcpadd":"Intermed,100 Foden Rd. East Ste 203","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":"6 LANDING RD","madd2":"","madd3":"","mcity":"SACO","mstate":"ME","mzip":"04072","pcpfaxno":2078741483,"pcpnpi":1346315637,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5AM2QK5CJ95","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G4733","K621","Z98890","Z0000","K8020","K5732","J069","E1165","E113299","Z794","I10","N83202","N83201","J029","R051","K439","K8070","K436","E1136","E6601","Z6838","R1013","K7689","E103393","H2513","K449","E113393","E039","Z23","J4540","Z1211","K5730","K222","D128","K5790","K219","R399","L7634","H6121","B349","Z1231","R059","R300","Z713","K430","Z0001","L02211","R6889","K8050","J45909","M8588","R6884","R519","J3489","R109","Z0184","R7989","H5213","M793","N390","K8064","Z0101","T8149XA","G4759","S62325D","R2232","H60543","E042","R252","E1159","H43812","E785"],"date":["2025-10-15","2023-07-17","2025-11-07","2025-03-31","2025-03-19","2025-02-27","2025-01-15","2025-01-08","2023-06-13","2023-06-13","2025-07-26","2024-01-16","2024-01-16","2025-03-18","2025-01-18","2025-05-09","2025-09-03","2025-09-03","2024-09-10","2024-01-12","2024-01-12","2025-03-19","2025-03-19","2025-05-08","2025-05-08","2025-05-07","2025-07-26","2024-12-04","2025-10-16","2025-05-05","2023-07-17","2023-07-17","2023-07-17","2023-07-17","2023-07-17","2025-09-03","2023-11-06","2025-09-29","2025-01-18","2025-01-18","2025-07-26","2025-01-18","2023-09-18","2025-01-08","2025-09-10","2024-12-11","2025-09-29","2023-12-08","2025-09-03","2025-09-03","2024-03-28","2025-09-23","2025-09-23","2025-09-23","2025-09-29","2025-03-31","2025-03-31","2025-05-08","2025-05-09","2023-12-01","2025-09-03","2024-06-18","2025-09-30","2024-11-05","2024-02-06","2024-02-06","2023-04-04","2025-05-21","2024-09-10","2024-09-10","2025-09-23","2024-12-04"],"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":[["","","OZEMPIC","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","ULTRA-FINE INSULIN SYRINGE","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","INSULIN SYRINGE","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","AIRSUPRA","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","DEXCOM G7 RECEIVER","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","MOMETASONE FUROATE","","","Select","Select",""],["","","LANTUS","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIP","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","INSULIN ASPART","","","Select","Select",""],["","","TRESIBA FLEXTOUCH U-100","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","LEVEMIR","","","Select","Select",""],["","","DEXCOM G6 SENSOR","","","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":""}]}]}