{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dorothy C Mcduffie","gend":1,"currentgend":"","add":"51 PIONEER AVE","city":"CARIBOU","state":"ME","zip":"04736","dob":"1943-06-29","age":"","mstatus":"","insh":"00008663300","cliId":"","pno":"2074986669","cno":"","email":"","ename":"","eno":"","pphy":"FLYNN, CARL E","ppno":"","pcpadd":"PO BOX 40,","pcpcity":"CARIBOU","pcpstate":"ME","pcpzip":"47360040","pcpcounty":"","pcpid":"","pcpname":"PINES CARIBOU HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2074986669","add2":"","add3":"","madd1":"51 PIONEER AVE","madd2":"","madd3":"","mcity":"CARIBOU","mstate":"ME","mzip":"04736","pcpfaxno":"2074983947","pcpnpi":"1609844422","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1NV3UY5JN85","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I639","Z803","M5450","M8588","M160","M539","M5459","M5417","M25552","M48061","Z0101","Z961","R7309","Z1231","R102","I10","S82831A","M47816","I519","Z8673","M5416","I119","S82831D","S93401A","M25512","Z7901","Z7951","Z79899","R000","I340","F419","E7849"],"date":["2023-04-24","2024-05-09","2023-06-16","2023-06-16","2023-06-16","2023-07-31","2023-11-01","2024-01-22","2023-11-09","2025-07-08","2025-04-25","2025-04-25","2024-04-04","2024-05-09","2024-07-10","2025-12-10","2025-09-02","2025-12-10","2025-12-10","2025-08-07","2024-07-24","2024-07-24","2025-10-28","2025-09-02","2025-09-02","2025-11-17","2025-11-17","2025-11-17","2023-03-02","2023-02-07","2023-01-26","2023-01-26"],"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":[["","","ALPRAZOLAM","1 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","VENLAFAXINE","150 MG","","Select","Select",""],["","","ADVAIR HFA","","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","Amoxicillin","500 MG","","Select","Select",""],["","","Triamcinolone Acet 0.5 % Cream Ascend Labs","","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","FLUTICASONE PROP\/SALMETEROL HFA","115\/21 MCG","","Select","Select",""],["","","FLUTICASONE PROP\/SALMETEROL","250\/50 MCG","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.005","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}