{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Eileen D Lowell","gend":1,"currentgend":"","add":"13 TEAL LN","city":"Bowdoinham","state":"ME","zip":"04008","dob":"1946-08-17","age":"","mstatus":"","insh":"10000021793","cliId":"","pno":"2076665517","cno":"","email":"Edl8172010@hotmail.com","ename":"","eno":"","pphy":"MCELHINNEY, KRISTINA E","ppno":"2078469013","pcpadd":"InterMed,259 Main St","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"13 TEAL LN","madd2":"","madd3":"","mcity":"Bowdoinham","mstate":"ME","mzip":"04008","pcpfaxno":"2078741483","pcpnpi":"1497073746","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7P23DK9EQ73","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N19","R059","J328","R918","J849","I10","D6489","J8410","J8489","N1831","I7090","J84112","D649","D704","D539","Z0000","N1832","M8580","M542","R519","Z23","J0180","Z0001","G243","H04123","H527","J984","R6889","C649","M79671","M9902","M9904","M9903","M9905","J300","M79672","M79673","I129","F411","G250","I2721","I081","M5134","M47814","M546","M9906","S22070A","M169","M5416","S8991XA","M47816","N2581","M8008XA","M8588","M4854XA","M25551","M5450","G8929","H26493","H40013","H903","M51360","Z8781","H6120","R944","E213","M810","R0781","R0902","R600","Z780","Z13820","M549","R0609","M4727","M4726","R030","R0789","J329","R809","D638"],"date":["2023-04-12","2023-04-12","2023-04-11","2023-04-12","2026-01-29","2024-06-13","2025-10-01","2026-01-29","2025-09-18","2025-05-16","2023-05-03","2023-05-03","2025-12-10","2023-06-07","2025-05-01","2025-10-06","2026-01-13","2025-04-10","2024-01-25","2023-09-06","2025-10-06","2023-09-06","2024-10-07","2026-01-28","2025-05-30","2025-05-30","2024-04-26","2023-11-12","2023-12-20","2024-02-05","2025-03-27","2025-03-27","2025-03-27","2025-03-27","2024-01-29","2024-02-05","2024-03-04","2025-05-01","2025-07-28","2024-03-26","2024-05-08","2024-05-08","2024-05-30","2025-10-03","2025-10-03","2024-06-04","2025-10-01","2024-10-22","2024-12-27","2024-10-22","2025-05-05","2025-10-13","2025-10-13","2025-10-13","2025-10-03","2025-02-12","2025-11-19","2025-11-19","2025-05-30","2025-05-30","2024-08-14","2025-04-10","2025-04-10","2025-10-01","2025-03-24","2025-10-01","2026-02-13","2025-10-20","2025-09-30","2025-08-21","2025-07-09","2025-07-07","2024-12-02","2024-09-20","2024-12-27","2024-12-30","2025-10-20","2025-10-20","2025-01-30","2025-05-01","2023-01-24"],"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":[["","","OFEV","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","NADOLOL","20 MG","","Select","Select",""],["","","CYCLOBENZAPRINE","5 MG","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","CLONAZEPAM","0.5 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","Metoprolol Succ","100 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","Calcitonin-Salmon 200 Units Nas Spray Par","","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","LOSARTAN","50 MG","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","Methocarbamol","500 MG","","Select","Select",""],["","","EVENITY","","","Select","Select",""],["","","PANTOPRAZOLE","20 MG","","Select","Select",""],["","","BUSPIRONE","15 MG","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Amneal","","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","Azelastine 0.1%","137 MCG","","Select","Select",""],["","","JASCAYD","","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","AZELASTINE (","0.1%) 137","","Select","Select",""],["","","IPRATROPIUM","0.0006","","Select","Select",""],["","","CALCITONIN-SALMON","200 UNITS","","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":""}]}]}