{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Brenda Wadleigh","gend":1,"currentgend":"","add":"711 SMITHFIELD RD","city":"Belgrade","state":"ME","zip":"04917","dob":"1947-03-18","age":"","mstatus":"","insh":"10000017839","cliId":"","pno":"2074652372","cno":"","email":"bndwadleigh@gmail.com","ename":"","eno":"","pphy":"CIANFARANO, ROBERT P","ppno":"2074652181","pcpadd":"4 CLEMENT WAY,","pcpcity":"BELGRADE","pcpstate":"ME","pcpzip":"04917","pcpcounty":"","pcpid":"","pcpname":"OAKLAND FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"711 SMITHFIELD RD","madd2":"","madd3":"","mcity":"Belgrade","mstate":"ME","mzip":"04917","pcpfaxno":"2074654629","pcpnpi":"1962591271","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9HF0FY3YM42","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","H6123","M25562","M25561","J3489","G4733","E782","I10","I480","E1149","K5190","E118","H3563","H43813","H26493","Z961","H5203","H52223","M7732","M79672","M7731","M79671","E876","E8352","I129","N1831","K5909","M5489","G8929","R109","B351","E1140","L602","L84","Z0001","E042","E079","Z041","R9089","G319","T148XXA","V499XXA","N281","K7689","M47812","R6889","Z1231","Z780","M8580","E041","R32","M170","D34","Z1211","D123","Z86010","E1165","K529","B3731","B372","E1122","K900","M2041","M2042","S91114A","K5792","M461","K5730","R1084","L728","I5033","S51011A","R42","K635","K621","I495","J029","Z471","K6389","Z98890","M25521","W19XXXA","Z789","E1121","E0590","M810","R059","R198","H938X3","I130","I509","I1310","M25552","M25559","E210","M5450","M79605","Z4789","M6740","Z4800","L03119","R58","H903","R0789","I498","R079","E1142","Z13820","K861","K5900","K829","M7122","M5442","M1711","R001","Z743","K828","I2510","S7012XA","I499","I444","Z5181","K219","Z860101","Z0000","H6121","K8590","G8911","R55","I484","M25551","L03316","M1611","S7002XA","E213","M25532","M47816","M47817","I700","W1830XA","Z7901","R300","T753XXA","M40204","M51369","Z01818","M549","R1011","G8918","Z7984"],"date":["2026-01-12","2024-08-04","2025-09-08","2025-03-11","2023-05-02","2026-01-14","2026-01-22","2025-05-03","2025-09-15","2023-05-17","2026-01-29","2025-07-14","2025-11-11","2023-07-18","2023-07-18","2025-11-11","2025-11-11","2025-11-11","2023-07-26","2023-07-26","2024-08-28","2023-07-26","2023-07-20","2024-09-03","2024-03-05","2025-02-24","2023-08-29","2024-07-23","2025-07-15","2024-11-18","2023-07-26","2023-07-26","2023-07-26","2024-11-25","2024-09-10","2025-11-01","2023-09-11","2023-09-22","2023-09-22","2023-09-22","2023-09-22","2023-09-22","2024-10-04","2023-09-22","2023-09-22","2023-08-09","2025-03-18","2023-10-19","2025-10-27","2023-10-30","2023-11-07","2025-09-08","2023-10-30","2025-06-23","2023-12-01","2024-02-15","2026-01-21","2023-12-11","2023-12-22","2023-12-22","2025-11-05","2026-01-29","2024-11-25","2024-11-25","2024-05-28","2024-06-03","2024-09-11","2025-06-23","2024-06-03","2024-05-28","2024-06-18","2025-12-11","2025-12-11","2025-06-23","2025-06-23","2024-10-06","2025-11-01","2026-01-15","2025-07-15","2025-09-08","2025-12-11","2025-12-11","2025-12-11","2025-03-12","2024-09-27","2025-10-22","2025-08-06","2025-08-06","2025-08-06","2025-11-05","2025-11-05","2025-03-06","2025-04-10","2025-04-10","2025-10-22","2024-09-26","2025-10-02","2024-08-28","2024-07-17","2024-08-24","2024-08-24","2025-06-19","2024-08-06","2024-11-19","2024-10-06","2025-11-01","2024-11-25","2025-10-21","2024-10-04","2024-10-04","2024-10-04","2025-10-02","2025-02-24","2025-02-24","2024-10-05","2024-10-05","2024-10-04","2024-09-30","2025-04-18","2024-10-09","2025-11-01","2025-06-06","2025-02-10","2025-02-10","2024-10-03","2025-11-05","2024-09-30","2025-05-03","2025-01-24","2023-03-24","2026-02-04","2025-07-28","2026-02-04","2025-04-10","2025-03-27","2025-11-05","2024-09-11","2024-09-11","2024-09-11","2025-04-10","2025-04-10","2025-09-19","2024-07-23","2025-07-15","2025-07-15","2025-04-03","2024-10-04","2024-10-07","2025-09-08","2023-02-06"],"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",""],["","","Mupirocin 2 % Ointment Taro","","","Select","Select",""],["","","FREESTYLE LITE","","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","Betamethasone Diprop 0.05 % Ointment Padag","","","Select","Select",""],["","","ALPRAZOLAM","0.5 MG","","Select","Select",""],["","","MESALAMINE","1.2 GM","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","LOSARTAN","100 MG","","Select","Select",""],["","","VENLAFAXINE","150 MG","","Select","Select",""],["","","MECLIZINE","25 MG","","Select","Select",""],["","","FLUCONAZOLE","100 MG","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","PROLIA","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","ROSUVASTATIN","5 MG","","Select","Select",""],["","","METRONIDAZOLE","500 MG","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","OXYBUTYNIN","5 MG","","Select","Select",""],["","","DICYCLOMINE","20 MG","","Select","Select",""],["","","TORSEMIDE","20 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","NYAMYC","","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","BAQSIMI","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","Journavx","","","Select","Select",""],["","","CAREONE UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","Bd Ultra-Fine Nano (Ref 320122)","","","Select","Select",""],["","","Lidocaine\/Prilocaine 2.5\/2.5 % Cream Fouge","","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","LEVOFLOXACIN","750 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","Insulin Degludec 200 Units\/Ml Inj (Pen) No","","","Select","Select",""],["","","Freestyle Precision Neo (Ref 71579-75)","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","TRESIBA FLEXTOUCH","","","Select","Select",""],["","","SCOPOLAMINE","1 MG\/72HR","","Select","Select",""],["","","Neo\/Polymyx\/Hydrocortisone 3.5\/10","","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","LIDOCAINE\/PRILOCAINE","2.5\/2.5 %","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","MUPIROCIN","0.02","","Select","Select",""],["","","CLOTRIMAZOLE","0.01","","Select","Select",""],["","","BD ULTRA-FINE NANO (REF","","","Select","Select",""],["","","NEO\/POLYMYX\/HYDROCORTISONE","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","BETAMETHASONE DIPROP","0.0005","","Select","Select",""],["","","INSULIN DEGLUDEC","200 UNITS\/ML","","Select","Select",""],["","","FREESTYLE PRECISION NEO (REF","","","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":""}]}]}