{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barbara L Lawrence","gend":1,"currentgend":"","add":"261 WESTERN AVE","city":"HAMPDEN","state":"ME","zip":"04444","dob":"1943-09-21","age":"","mstatus":"","insh":"10000016182","cliId":"","pno":"2078623566","cno":"","email":"bblegmbarb@roadrunner.com","ename":"","eno":"","pphy":"PATTEN, JOHN L","ppno":"2078620300","pcpadd":"St Joseph Family Medicine Hampden,21 Western Ave","pcpcity":"Hampden","pcpstate":"ME","pcpzip":"04444","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"261 WESTERN AVE","madd2":"","madd3":"","mcity":"HAMPDEN","mstate":"ME","mzip":"04444","pcpfaxno":"2077778800","pcpnpi":"1669577938","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5CX4YQ7NX84","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79652","I82812","R202","R5383","Z136","Z0000","R7301","M7989","R2242","R600","R002","Z0189","R6889","I10","Z0101","H5213","H52223","H524","H2513","H43813","I739","R0601","E6601","R0609","J9621","J9622","J9600","H2512","J9690","I110","R918","H40031","H2511","Z961","I517","I509","R7981","R0600","R0902","K8020","I4892","I252","I459","M5450","F17210","M9905","J449","I480","J9811","J189","J90","H18553","Z09","I4891","L299"],"date":["2023-08-16","2023-08-16","2023-09-11","2023-09-14","2023-09-14","2025-11-05","2023-09-14","2023-10-01","2023-10-02","2023-10-02","2023-10-03","2023-08-15","2023-05-07","2025-10-23","2025-03-20","2025-04-10","2025-04-10","2025-04-10","2024-09-04","2024-01-05","2024-01-16","2024-03-29","2024-03-29","2024-09-25","2025-06-14","2025-05-14","2025-05-14","2024-09-17","2025-05-15","2025-09-23","2025-05-03","2026-02-24","2025-12-09","2025-12-09","2025-05-08","2025-05-01","2025-05-01","2025-05-01","2025-05-05","2025-05-06","2025-05-02","2025-05-02","2025-05-08","2025-09-23","2024-10-28","2025-11-05","2025-05-14","2025-10-23","2025-05-11","2025-05-01","2025-05-11","2025-10-14","2025-05-16","2025-05-16","2025-05-16"],"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":[["","","Moxifloxacin 0.5 % Ophth Sol Lupin","","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","ATORVASTATIN","40 MG","","Select","Select",""],["","","DULERA","","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","Moxifloxacin 0.5 % Ophth Sol Aurobindo","","","Select","Select",""],["","","LOSARTAN","25 MG","","Select","Select",""],["","","METOPROLOL TART","25 MG","","Select","Select",""],["","","POTASSIUM CL","10 MEQ","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","MOXIFLOXACIN","0.005","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","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":""}]}]}