{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Cynthia J Mcdougall","gend":1,"currentgend":"","add":"183 HARPSWELL NECK RD","city":"Harpswell","state":"ME","zip":"04079","dob":"1948-02-01","age":"","mstatus":"","insh":"10000020585","cliId":"","pno":"2077257585","cno":"","email":"cjmcd@comcast.com","ename":"","eno":"","pphy":"UDUEBOR, MIRIAM","ppno":"","pcpadd":"Martins Point Health Care,\t114 Bath Rd","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"183 HARPSWELL NECK RD","madd2":"","madd3":"","mcity":"Harpswell","mstate":"ME","mzip":"04079","pcpfaxno":"2076267401","pcpnpi":"1477120590","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5R02AG2GM28","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":["H6121","R0781","M5481","M5416","S76311A","M66351","M7062","R350","M1712","M25562","N390","M7918","S76311D","M5450","M533","R1011","R109","K439","N281","K760","G4733","M2040","L851","E785","I10","R4182","R300","Z96652","G4730","A000","R110","T8484XA","Y792","T84018A","F418","G8918","F4320","Z96653","M25462","Z471","R32","N3289","U071","M47814","K432","M461","M5417","F419","R7303","Z1231","H40013","H16223","G43909","R399","M25551","M7061","M4726","S76311S","M160","G43711","R197","D729","E876","Z4789","S76392D","R1110"],"date":["2023-08-14","2023-04-12","2024-05-22","2023-04-17","2023-04-24","2024-01-04","2024-05-23","2023-06-28","2023-09-07","2023-11-28","2024-05-10","2023-07-12","2023-06-14","2024-01-18","2024-03-20","2023-07-17","2023-07-17","2023-07-17","2023-07-17","2023-07-17","2023-08-17","2023-07-24","2023-07-24","2024-02-27","2023-09-07","2023-07-26","2024-02-27","2023-11-28","2023-08-29","2023-09-09","2023-08-29","2023-09-07","2023-09-07","2023-09-07","2023-09-07","2023-09-07","2023-09-08","2023-09-07","2023-09-21","2023-09-21","2023-10-10","2023-10-10","2023-12-11","2023-12-11","2024-03-05","2024-02-29","2024-01-31","2024-01-31","2024-02-27","2024-03-07","2024-03-12","2024-03-12","2024-04-08","2024-05-09","2024-05-23","2024-05-23","2024-05-23","2024-05-23","2024-05-23","2024-05-22","2024-07-05","2024-06-24","2024-06-26","2024-07-12","2024-07-12","2024-07-05"],"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":[["","","Lovastatin","40 MG","","Select","Select",""],["","","Celecoxib","200 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Aimovig","","","Select","Select",""],["","","Mupirocin 2 % Ointment Padagis","","","Select","Select",""],["","","Oxybutynin","5 MG","","Select","Select",""],["","","Duloxetine","60 MG","","Select","Select",""],["","","Cyclobenzaprine","5 MG","","Select","Select",""],["","","Gabapentin","800 MG","","Select","Select",""],["","","Doxycycline Monohydrate","100 MG","","Select","Select",""],["","","Ketorolac","10 MG","","Select","Select",""],["","","Estradiol 0.01 % Vag Cream Padagis","","","Select","Select",""],["","","Mirtazapine","15 MG","","Select","Select",""],["","","Nitrofurantoin Macro\/Mono","100 MG","","Select","Select",""],["","","Meclizine","25 MG","","Select","Select",""],["","","Mupirocin 2 % Ointment Encube","","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Fluzone High Dose","","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Ondansetron","4 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","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":""}]}]}