{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Candace H Smith","gend":1,"currentgend":"","add":"364 LEDGE RD","city":"North Yarmouth","state":"ME","zip":"04097","dob":"1947-09-09","age":"","mstatus":"","insh":"10000019489","cliId":"","pno":"2078463464","cno":"","email":"2sons@maine.rr.com","ename":"","eno":"","pphy":"WADLAND, WILLIAM R","ppno":"2078282402","pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"364 LEDGE RD","madd2":"","madd3":"","mcity":"North Yarmouth","mstate":"ME","mzip":"04097","pcpfaxno":"2078287850","pcpnpi":"1154499002","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4CF3N01QF17","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K7460","K5900","R1032","M25551","C50911","Z170","J300","R911","M79671","R262","R202","M205X1","Z96641","Z5112","C787","R110","H2512","H25811","H16223","Z79811","Z9222","D500","L602","Z01818","I5189","I361","H259","D509","H0288A","H0288B","H353131","J984","I2510","R0602","R1011","K810","C50919","D649","K828","F341","R109","R4182","C7981","C801","L989","I6782","I081","I2720","D6481","K766","L600","L608","R197","K769","Z853","R194","Z23","J310","H02051","H02054","H35363","Z79899","R6889","R945","Z5181","J3489","R5383","H04123","E7800","M810","M79672","M7061","H43813","H3581","Z5111","M8588","Z0101","Q828","G8929","I088","N390","T80219A","A4902","K449","I8500","M79661","W19XXXA","E860","I8510","M79662","C50912","R188","J0190","T80212A","K219","E785","K319","I083","T827XXA","K5730","M1712","R600","M818","R2689","G609","H02052","Z171","J90","H2513","R918","L03313","K7689","B351","R519","R634","I517","L851","L84","R978","R630","M25562","J849","U071","H02203","H02206"],"date":["2026-01-30","2025-06-18","2025-02-05","2024-03-04","2026-03-06","2026-01-09","2023-04-11","2025-03-13","2023-04-17","2026-01-05","2023-04-17","2024-06-13","2024-11-13","2025-10-29","2025-11-03","2023-04-19","2023-06-01","2023-06-01","2024-06-12","2025-04-24","2025-01-24","2023-05-31","2026-03-05","2026-02-16","2023-06-20","2023-06-20","2023-05-11","2025-08-27","2023-06-20","2023-06-20","2025-06-27","2023-06-28","2023-06-28","2023-06-28","2023-06-28","2023-06-28","2025-11-10","2025-06-23","2023-06-28","2023-03-31","2024-09-11","2025-03-26","2023-07-13","2023-07-13","2023-08-02","2023-08-28","2023-08-30","2023-08-30","2025-08-22","2025-12-17","2025-12-04","2026-01-05","2025-02-28","2023-09-26","2024-01-11","2024-09-11","2025-10-30","2023-10-26","2024-09-12","2023-11-09","2025-06-05","2024-04-12","2023-11-27","2024-01-09","2025-01-21","2024-01-09","2025-03-28","2024-06-12","2024-04-08","2024-12-31","2024-04-08","2024-11-13","2025-06-27","2025-06-27","2026-02-19","2024-05-03","2024-06-05","2024-06-13","2024-09-11","2024-10-30","2026-02-06","2025-11-03","2025-11-03","2024-10-06","2025-07-11","2025-09-23","2025-09-23","2026-02-21","2025-12-17","2025-09-23","2026-02-16","2026-01-27","2024-12-20","2025-10-20","2025-03-26","2025-03-26","2025-03-26","2025-03-21","2025-09-25","2025-02-05","2025-12-03","2025-07-02","2025-04-24","2026-03-05","2025-08-21","2024-08-13","2023-03-31","2023-03-31","2023-03-24","2025-09-23","2025-09-24","2024-11-05","2025-03-20","2026-02-16","2026-02-16","2025-11-03","2026-03-05","2026-03-05","2024-11-04","2024-11-04","2025-12-03","2024-11-21","2023-02-27","2023-02-02","2023-02-02"],"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":[["","","RESTASIS","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray West-Ward","","","Select","Select",""],["","","CAPECITABINE","500 MG","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","Tobramycin 0.3 % Ophth Sol Somerset","","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Sandoz","","","Select","Select",""],["","","ESCITALOPRAM","5 MG","","Select","Select",""],["","","EXEMESTANE","25 MG","","Select","Select",""],["","","DICYCLOMINE","10 MG","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","CARVEDILOL","3.125 MG","","Select","Select",""],["","","NADOLOL","20 MG","","Select","Select",""],["","","Cyclosporine Pf 0.05 % Ophth Emuls Mylan","","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","TUKYSA","","","Select","Select",""],["","","ALPRAZOLAM","0.25 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","236 GM","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","Ipratropium 0.03 % Nas Spray West-Ward","","","Select","Select",""],["","","CEFPODOXIME","200 MG","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Advagen","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Amneal","","","Select","Select",""],["","","Ipratropium 0.03 % Nas Spray Amneal","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","Chlorhexidine 0.12 % Oral Rinse Xttrium","","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","BUPROPION HCL","150 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","IBRANCE","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","LIDOCAINE-PRILOCAINE","","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","SPIRONOLACTONE","50 MG","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","Fluad Quad 2023-2024","","","Select","Select",""],["","","COLESTIPOL","1 GM","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","LETROZOLE","2.5 MG","","Select","Select",""],["","","TRAZIMERA","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","Ketorolac 0.5 % Ophth Sol Apotex","","","Select","Select",""],["","","OLANZAPINE","5 MG","","Select","Select",""],["","","Neo\/Polymyx\/Dex 3.5\/10","","","Select","Select",""],["","","NEO\/POLYMYX\/DEX","","","Select","Select",""],["","","IPRATROPIUM","0.0003","","Select","Select",""],["","","FLUAD QUAD","","","Select","Select",""],["","","CYCLOSPORINE PF","0.0005","","Select","Select",""],["","","TOBRAMYCIN","0.003","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","Select","Select",""],["","","PEG","3350\/ELECTROLYTES 236","","Select","Select",""],["","","CHLORHEXIDINE","0.0012","","Select","Select",""],["","","KETOROLAC","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":[]}},{"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":""}]}]}