{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Linda R Cormier","gend":1,"currentgend":"","add":"28 PARKWOODS DR APT 3","city":"ANSON","state":"ME","zip":"04911","dob":"1949-01-29","age":"","mstatus":"","insh":"10000031517","cliId":"","pno":"2074745899","cno":"","email":"declined@09242025.COM","ename":"","eno":"","pphy":"BANKS PAULINO, ANGELA R","ppno":"2074740905","pcpadd":"Redington Medical Primary Care,46 Fairview Ave Primary Care Ste 111","pcpcity":"Skowhegan","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"REDINGTON MEDICAL PRIMARY CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"28 PARKWOODS DR APT 3","madd2":"","madd3":"","mcity":"ANSON","mstate":"ME","mzip":"04911","pcpfaxno":"2074746930","pcpnpi":"1942795885","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4RH2JX9JG29","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","Z0000","Z1231","I10","Z0101","H5203","E113291","E113212","H401131","H04123","E6601","M19041","R9082","I4892","R29898","I6523","U071","I639","R2681","R5381","I69398","I6381","I69351","I69359","E113293","Z13820","Z1211","R7303","M159","M25562","Z8673","Z7982","Z7902","R062"],"date":["2023-05-27","2025-05-30","2023-06-30","2024-11-21","2025-06-09","2023-09-19","2023-09-19","2023-09-19","2025-12-18","2025-12-18","2024-10-01","2023-12-11","2024-01-02","2024-01-03","2023-12-31","2025-07-29","2024-01-05","2024-01-23","2024-01-25","2024-01-25","2024-02-02","2024-01-02","2024-03-05","2024-04-16","2025-12-18","2024-06-24","2024-10-01","2024-10-01","2024-10-01","2025-09-04","2025-07-29","2025-07-29","2025-07-29","2026-02-13"],"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":[["","","HYDROCHLOROTHIAZIDE","12.5 MG","","Select","Select",""],["","","METOPROLOL TART","100 MG","","Select","Select",""],["","","SERTRALINE","25 MG","","Select","Select",""],["","","LOSARTAN","50 MG","","Select","Select",""],["","","ALENDRONATE","70 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Somerset","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Sandoz","","","Select","Select",""],["","","LATANOPROST","0.00005","","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":""}]}]}