{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Maureen A Anthony","gend":1,"currentgend":"","add":"87 RIDGEWOOD DR","city":"FALMOUTH","state":"ME","zip":"04105","dob":"1943-12-29","age":"","mstatus":"","insh":"00008091200","cliId":"","pno":"2076509924","cno":"","email":"Manthoine1@gmail.com","ename":"","eno":"","pphy":"EMERY, PETER","ppno":"2077745816","pcpadd":"100 FODEN RD WEST,STE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2076509924","add2":"","add3":"","madd1":"87 RIDGEWOOD DR","madd2":"","madd3":"","mcity":"FALMOUTH","mstate":"ME","mzip":"04105","pcpfaxno":"2078741483","pcpnpi":"1649239765","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9D59V76AD46","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F900","F331","M9901","M9900","M9902","M542","M25511","F341","Z1211","Z86010","K219","E785","D120","D123","D125","M47812","M4312","G8929","R531","N3001","R269","R296","R2681","H5500","Z23","N952","R300","R251","I679","R110","R3911","D492","C44319","S8992XA","H35372","H40023","H18593","H33312","H43813","H35042","G43909","S82851A","F32A","S82841A","M79671","W1849XA","W19XXXA","S8251XA","S8261XA","S93401A","M25471","G4730","F419","S82851D","S0990XA","I672","R1030","D251","E039","M8008XD","I951","K559","R519","S0083XA","R001","M4316","M48061","Z0001","N852","D259","Z4802","M4807","M5127","M51369","M47817","K922","S199XXA","M8448XA","B029","M25571","Z0000","S32049S","R262","R220","M810","I4710","I498","R079","S32010D","Z1231","S32048D","M47816","M5450","S32010A","M8008XA","S32049D","I82622","S0101XA","D649","M549","M4802","S32010G","S299XXA","S3991XA","S3993XA","S0003XA","L219","L821","D1801","Z85828","S0181XA","R55","S32049A","I82612","Z87891","Z09","M9908","G250","R5383","Z9181","F321","F411","K5909","R8290","R32","M5126","M51360","Z452","G3184","Z79899","E559","I080","R58","R059","R0989","R042","M9909"],"date":["2025-12-11","2025-12-11","2023-05-05","2023-05-05","2023-05-05","2024-03-04","2023-05-05","2023-05-05","2023-05-31","2023-05-31","2026-01-14","2026-01-14","2023-05-31","2023-05-31","2023-05-31","2023-10-24","2023-07-03","2025-10-30","2024-11-26","2023-10-30","2024-11-21","2024-12-03","2025-09-19","2023-10-30","2023-11-08","2023-11-28","2025-10-25","2024-11-19","2023-12-14","2024-03-04","2024-08-16","2024-02-13","2024-05-10","2024-04-14","2024-04-29","2024-04-29","2024-03-27","2024-04-29","2024-04-29","2024-05-13","2024-11-13","2024-08-30","2024-06-05","2024-08-02","2024-06-01","2024-06-01","2024-11-27","2024-06-02","2024-06-02","2024-06-01","2024-06-01","2024-06-02","2025-09-19","2024-08-28","2024-11-26","2024-06-02","2025-10-02","2025-10-02","2026-01-14","2025-05-21","2024-11-27","2025-11-17","2024-10-24","2026-03-02","2025-01-08","2026-02-26","2026-02-26","2024-08-16","2025-11-26","2025-09-29","2024-10-18","2025-07-12","2025-07-12","2025-07-12","2026-02-25","2025-11-26","2026-03-02","2025-04-25","2023-03-31","2024-11-08","2025-06-23","2025-09-19","2025-09-19","2024-10-09","2025-04-16","2024-12-06","2024-12-06","2025-01-08","2025-07-30","2025-04-15","2025-01-01","2025-04-25","2026-02-25","2026-02-25","2026-01-14","2024-12-13","2024-12-13","2024-12-13","2024-06-10","2025-10-30","2024-12-04","2026-01-14","2024-11-26","2024-11-26","2024-11-26","2026-03-02","2025-03-24","2025-03-24","2025-03-24","2025-03-24","2024-10-23","2024-11-27","2024-11-27","2024-12-04","2026-01-14","2024-08-02","2023-03-31","2023-03-31","2025-08-30","2025-08-30","2025-09-04","2025-09-04","2025-09-04","2025-10-20","2025-10-30","2025-10-30","2026-02-25","2025-11-14","2024-12-03","2024-12-03","2024-12-03","2024-11-29","2024-10-09","2023-01-19","2023-01-19","2023-01-19","2023-01-19"],"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":[["","","DEXTROAMPHET\/AMPHET","10 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","Bupropion Hcl","200 MG","","Select","Select",""],["","","CLONAZEPAM","2 MG","","Select","Select",""],["","","FLUCONAZOLE","150 MG","","Select","Select",""],["","","BUPROPION HCL SR","","","Select","Select",""],["","","SUMATRIPTAN","6 MG\/0.5","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","ALENDRONATE","70 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Taro","","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","VALACYCLOVIR","1 GM","","Select","Select",""],["","","METRONIDAZOLE","500 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Taro","","","Select","Select",""],["","","Prednisone","10 MG","","Select","Select",""],["","","Fluocinonide 0.05 % Top Sol Encube","","","Select","Select",""],["","","HYDROXYZINE HCL","10 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","LEVOFLOXACIN","750 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","ADDERALL","","","Select","Select",""],["","","PFIZER-BIONTECH GRAY","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHET ER","","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","PREVNAR","","","Select","Select",""],["","","FLUOCINONIDE","0.0005","","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":""}]}]}