{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Judy M Elliott","gend":1,"currentgend":"","add":"37 OTTER DR","city":"Standish","state":"ME","zip":"04084","dob":"1946-01-28","age":"","mstatus":"","insh":"10000026289","cliId":"","pno":"2076534417","cno":"","email":"crjelliott@roadrunner.com","ename":"","eno":"","pphy":"WATTS, JENNIFER L","ppno":"2078392559","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":"37 OTTER DR","madd2":"","madd3":"","mcity":"Standish","mstate":"ME","mzip":"04084","pcpfaxno":"2075231135","pcpnpi":"1679926828","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3PV6D35VP46","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":["Z1389","E782","E8352","I10","C641","Z0101","H40023","R911","Z1231","N909","Z1151","Z853","R918","C649","C50911","G9389","C55","D72829","R7401","L821","D1801","L814","Z85828","C718","R059","C7931","Z85528","Z510","C7900","E871","E559","E673","E279","G936","Z923","C7800","J90","F4320","Z79899","R945","C760","T8544XA","Z9882","Z5112","R21","D492","C801","D0461","H40013","H35363","D225","R109","Z7189","R530","E876","K1231","Z08","Z85841","J069","M542","M9900","M9901","M9902","M5450","N3000","Z23","Z515"],"date":["2023-04-19","2025-10-23","2025-06-26","2025-10-23","2026-03-05","2025-09-24","2025-09-24","2025-06-24","2025-08-08","2023-08-10","2023-09-06","2025-06-26","2024-11-26","2025-06-24","2023-09-12","2023-09-22","2023-09-22","2023-10-04","2023-10-04","2025-10-16","2025-10-16","2025-10-16","2023-10-04","2023-09-26","2023-10-25","2026-03-05","2024-06-14","2024-06-14","2024-05-02","2023-11-22","2024-12-05","2024-03-19","2023-12-13","2024-01-24","2024-05-30","2024-03-13","2024-03-13","2024-07-30","2024-06-24","2024-04-17","2024-04-24","2024-04-24","2024-04-24","2024-06-25","2024-07-25","2025-07-02","2024-06-12","2025-07-02","2024-09-12","2024-09-12","2025-10-16","2024-10-24","2026-02-05","2026-03-05","2024-10-11","2024-07-25","2024-05-30","2024-05-30","2025-11-10","2025-10-15","2025-10-15","2025-10-15","2025-10-15","2025-08-07","2025-11-26","2025-10-02","2024-07-30"],"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":[["","","TRIAMTERENE\/HYDROCHLOROTHIAZIDE","37.5\/25 MG","","Select","Select",""],["","","CABOMETYX","","","Select","Select",""],["","","Hydrocortisone 2.5 % Rec Cream Ani Pharm","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Perrigo","","","Select","Select",""],["","","LEVOFLOXACIN","500 MG","","Select","Select",""],["","","POTASSIUM CL","20 MEQ","","Select","Select",""],["","","PROCTO-MED HC","","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","ONDANSETRON","8 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","DEXAMETHASONE","4 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","CLINDAMYCIN","150 MG","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","DIPHENOX\/ATROPINE","2.5\/0.025 MG","","Select","Select",""],["","","OLANZAPINE","2.5 MG","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","Lidocaine Viscous 2 % Oral Top Sol West-Wa","","","Select","Select",""],["","","HYDROCORTISONE","0.025","","Select","Select",""],["","","PREVNAR","","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","LIDOCAINE VISCOUS","0.02","","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":""}]}]}