{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Shirley E Soucie","gend":1,"currentgend":"","add":"170 BULLEN ST","city":"MILFORD","state":"ME","zip":"04461","dob":"1948-11-12","age":"","mstatus":"","insh":"10000027617","cliId":"","pno":"2076071256","cno":"","email":"HUGGER48@YAHOO.COM","ename":"","eno":"","pphy":"PROKOPOVA, KATARINA","ppno":"2078276605","pcpadd":"PO BOX 1599,","pcpcity":"BANGOR","pcpstate":"ME","pcpzip":"44021599","pcpcounty":"","pcpid":"","pcpname":"HELEN HUNT HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"170 BULLEN ST","madd2":"","madd3":"","mcity":"MILFORD","mstate":"ME","mzip":"04461","pcpfaxno":"2079470435","pcpnpi":"1366479875","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7M02YQ0UN10","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0101","H40013","H524","E785","E039","I77810","I517","M19031","M1811","M19041","G4733","Z0000","N182","E870","R300","E6601","Z9884","I10","K909","R7889","R7301","Z114","Z4789","Z981","M654","Z471","Z96698","N3000","Z1231","Z780","I83813","I872","M160","N3001","I493","Z23","Z96691","Z87440","N281","E669","Z96653","I6523","E673","Z1211","Z86010","D120","N390"],"date":["2024-05-02","2024-05-02","2024-05-02","2024-06-21","2024-04-29","2023-05-08","2024-05-01","2023-08-31","2023-08-31","2023-08-31","2024-06-30","2023-07-31","2023-06-16","2023-06-16","2023-09-18","2023-07-26","2023-07-26","2024-06-21","2023-07-26","2023-07-31","2024-06-21","2023-07-31","2023-09-15","2023-09-05","2023-08-31","2024-04-02","2023-10-11","2023-09-18","2023-09-20","2023-09-20","2023-09-25","2023-09-25","2023-12-12","2024-01-18","2023-12-07","2023-10-26","2023-11-15","2024-01-16","2024-01-16","2024-04-29","2024-04-02","2024-05-17","2024-06-21","2024-07-02","2024-07-02","2024-07-02","2024-07-03"],"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":[["","","Fluconazole","150 MG","","Select","Select",""],["","","Topiramate","25 MG","","Select","Select",""],["","","Acetaminophen\/Codeine Phos","300\/30 MG","","Select","Select",""],["","","Levothyroxine","25 MCG","","Select","Select",""],["","","Lisinopril","20 MG","","Select","Select",""],["","","Cefpodoxime","200 MG","","Select","Select",""],["","","Rosuvastatin","5 MG","","Select","Select",""],["","","Atorvastatin","20 MG","","Select","Select",""],["","","Estradiol 0.01 % Vag Cream Padagis","","","Select","Select",""],["","","Allopurinol","100 MG","","Select","Select",""],["","","Nitrofurantoin Macro\/Mono","100 MG","","Select","Select",""],["","","Bupropion Hcl Sr","","","Select","Select",""],["","","Levofloxacin","250 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","Select","Select",""],["","","Meclizine","25 MG","","Select","Select",""],["","","Losartan","50 MG","","Select","Select",""],["","","Metoprolol Succ","25 MG","","Select","Select",""],["","","Amoxicillin\/Clav","875\/125 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Ciprofloxacin","250 MG","","Select","Select",""],["","","Endocet","","","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":""}]}]}