{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Martha M Shores","gend":1,"currentgend":"","add":"81 HOLT RD","city":"CLINTON","state":"ME","zip":"04927","dob":"1932-12-27","age":"","mstatus":"","insh":"10000010268","cliId":"","pno":"2074269064","cno":"","email":"delcined@010226.com","ename":"","eno":"","pphy":"KNAUSENBERGER, ROLAND H","ppno":"","pcpadd":"Thayer Internal Medicine,149 North St Dept IM","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"THAYER INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"81 HOLT RD","madd2":"","madd3":"","mcity":"CLINTON","mstate":"ME","mzip":"04927","pcpfaxno":"2078613281","pcpnpi":"1952406308","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5R76Y03VQ58","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H35372","H353122","H353213","H43813","H353210","G43109","S80861A","H5310","R0989","R300","Z87440","W57XXXA","E039","R2689","I10","M19042","D485","L570","C44321","C44311","D0439","K5731","K922","K921","N390","Z23","D62","Z0101","R6889","M1611","R42","M25562","M1612","S79912A","K838","R935","D3502","K5730","L03012","M1712","J181","M48061","I509","R0602","R531","J189","Z789","M5417","J329","R2681","I5032","I083","I2720","M25551","M79604","C44319","C44629","E876","D0462","L739","M79605","R1031","R011","M25559","E278","M19012","M25712","M25512","M19011","M25711","M25511","J90","R918","E041","I2510","N281","D72829","R059","J439","Z01818","M25552","M48062","T8062XA","R051","Z20818","Z743","K831"],"date":["2025-06-12","2025-06-12","2025-06-12","2025-06-12","2023-05-09","2023-05-09","2023-05-26","2023-05-12","2023-05-26","2023-05-05","2023-05-05","2023-05-26","2025-09-18","2026-02-28","2026-01-27","2023-07-13","2024-08-20","2024-08-20","2023-08-14","2023-08-14","2023-08-14","2023-09-17","2024-04-30","2023-09-17","2025-08-16","2023-09-25","2023-09-20","2024-11-01","2023-10-18","2023-11-07","2024-11-07","2026-02-28","2025-12-30","2024-04-23","2024-04-30","2024-04-30","2024-04-30","2025-08-03","2024-06-02","2024-11-08","2025-09-22","2025-06-24","2025-09-08","2025-08-01","2025-08-01","2025-11-13","2025-08-01","2025-07-19","2026-01-11","2026-02-28","2025-08-25","2024-12-26","2024-12-26","2025-06-24","2025-06-24","2024-08-20","2024-08-20","2024-11-26","2024-08-20","2024-08-20","2025-08-19","2024-09-16","2024-12-26","2025-07-31","2025-07-31","2025-08-01","2025-08-01","2025-08-01","2025-08-01","2025-08-01","2025-08-01","2025-08-03","2025-07-31","2025-07-31","2025-08-03","2025-08-03","2025-07-14","2025-07-28","2025-07-28","2026-01-27","2026-01-27","2025-07-19","2025-11-13","2025-03-05","2025-03-05","2025-06-24","2023-01-17"],"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":[["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","LEVOTHYROXINE","25 MCG","","Select","Select",""],["","","TRAMADOL","25 MG","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","NIFEDIPINE ER","","","Select","Select",""],["","","NALOXONE","4 MG\/ACTUATION","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","CEFPODOXIME","200 MG","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","KAPSPARGO SPRINKLE","","","Select","Select",""],["","","TORSEMIDE","5 MG","","Select","Select",""],["","","NIFEDIPINE","60 MG","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","LISINOPRIL","5 MG","","Select","Select",""],["","","PREVNAR","","","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":""}]}]}