{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Hazel S Hinkley","gend":1,"currentgend":"","add":"440 CARDING MACHINE ROAD","city":"Bowdoinham","state":"ME","zip":"04008","dob":"1936-12-10","age":"","mstatus":"","insh":"10000038807","cliId":"","pno":"2077378625","cno":"","email":"decline@091819.com","ename":"","eno":"","pphy":"TRAPP, KATHLEEN R","ppno":"2077984400","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":"440 CARDING MACHINE ROAD","madd2":"","madd3":"","mcity":"Bowdoinham","mstate":"ME","mzip":"04008","pcpfaxno":"2078287850","pcpnpi":"1386603397","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3CQ0NM8TY49","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":["K625","K922","I4821","K6389","D122","K921","K5730","K91840","Z7901","K635","E119","H25811","H04123","H26492","H31003","R6889","K5731","Z66","I10","E669","E1165","I4811","N179","M810","Z8551","E559","Z79899","M19011","M25511","G8929","I4891","I69320","I639","R0989","R509","R0682","E1140","D62","E7800","M159","J129","I5030","J1282","N1830","N3289","I77810","R4182","R531","R059","R0602","Z7401","Z98890","K8020","G319","J9601","N189","I129","I083","M79604","D509","M150","R0600","M25551","M47816","M160","M79651","R9089","S79911A","M8580","M1611","I6523","I672","Q281","R918","A419","I517","D649","R011","J159","K644","I088","I69959","Z7409","I4820","I071","I340"],"date":["2023-04-06","2025-10-11","2025-11-06","2023-04-06","2023-04-06","2025-10-11","2023-04-06","2023-04-06","2023-04-06","2023-04-06","2025-06-27","2024-05-22","2023-05-22","2023-05-22","2024-10-02","2023-05-26","2023-04-06","2023-04-06","2025-06-27","2023-04-06","2025-06-27","2023-08-03","2023-08-03","2025-08-18","2026-01-09","2025-06-27","2025-06-27","2024-03-08","2024-04-29","2024-03-08","2026-01-22","2026-02-02","2025-10-01","2025-09-02","2025-09-02","2025-09-02","2025-09-03","2025-09-03","2025-06-27","2024-08-08","2026-01-30","2026-01-30","2026-01-30","2026-02-10","2025-01-02","2026-02-09","2025-10-16","2026-01-23","2026-01-24","2026-01-20","2025-09-03","2024-12-04","2025-10-11","2025-10-11","2026-01-20","2026-01-18","2026-01-18","2025-08-23","2025-05-20","2025-08-21","2025-03-11","2026-01-18","2025-05-20","2025-05-20","2025-05-20","2025-05-20","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2025-08-22","2026-01-18","2026-01-18","2026-01-22","2025-08-21","2025-08-21","2026-01-18","2025-10-13","2026-01-22","2026-01-23","2026-01-23","2023-03-13","2023-03-13","2023-03-13"],"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":[["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","PROCTO-MED HC","","","Select","Select",""],["","","WARFARIN","2.5 MG","","Select","Select",""],["","","Doxycycline Hyclate","100 MG","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","PROLIA","","","Select","Select",""],["","","LOSARTAN","50 MG","","Select","Select",""],["","","ALBUTEROL\/IPRATROPIUM","3\/0.5 MG\/3","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Encube","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","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":""}]}]}