{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Valerie J Rice","gend":1,"currentgend":"","add":"924 TUNK LAKE RD","city":"SULLIVAN","state":"ME","zip":"04664","dob":"1946-06-08","age":"","mstatus":"","insh":"10000039405","cliId":"","pno":"2074222030","cno":"","email":"declined@12092025.com","ename":"","eno":"","pphy":"HANSON, CASEY S","ppno":"2076675899","pcpadd":"PO BOX 8,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46090008","pcpcounty":"","pcpid":"","pcpname":"TRENTON HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"924 TUNK LAKE RD","madd2":"","madd3":"","mcity":"SULLIVAN","mstate":"ME","mzip":"04664","pcpfaxno":"2078015123","pcpnpi":"1164536397","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3KU0X38MN24","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I5030","I2510","I10","G4730","E133213","E1142","Z0000","I2720","M1611","I77819","M5459","M9903","M9902","M546","M25552","J90","J811","R600","R0602","R079","J449","J9621","I110","I081","I509","G4733","G4736","I493","I480","R42","Z5189","Z515","E1165","E6601","S30860A","I4891","R768","E1140","M7531","E119","Z0101","H52223","L570","M62838","D225","L821","L814","Z7189","M25512","M19012","J329","M85852","D2272","D1801","D485","S0096XA","Z13820","Z23","H5213","R197","R9431","Z79899"],"date":["2026-01-06","2025-05-02","2025-01-31","2023-08-07","2023-08-21","2025-04-15","2025-09-22","2025-04-30","2023-09-08","2024-06-26","2023-10-06","2023-10-06","2023-10-06","2023-10-06","2024-01-17","2024-02-06","2024-02-06","2024-02-06","2024-02-05","2024-02-05","2026-03-09","2026-03-09","2024-03-08","2024-02-06","2025-04-30","2025-04-30","2024-02-24","2024-02-24","2024-10-07","2024-02-05","2024-05-06","2024-08-15","2024-09-19","2026-02-06","2024-06-17","2025-03-17","2025-01-24","2026-02-03","2025-02-04","2025-09-16","2025-09-04","2025-09-04","2025-04-24","2024-10-09","2025-04-24","2025-04-24","2025-04-24","2025-04-24","2025-08-28","2025-09-25","2025-11-11","2024-10-25","2024-08-07","2024-08-07","2024-08-07","2024-10-30","2024-10-25","2025-10-07","2024-08-30","2023-02-17","2023-02-06","2023-02-02"],"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":[["","","MYRBETRIQ","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","FLUCONAZOLE","150 MG","","Select","Select",""],["","","TRUE METRIX","","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","METOPROLOL TART","100 MG","","Select","Select",""],["","","Embecta Nano 2Nd Gen (Ref 320550)","","","Select","Select",""],["","","LOSARTAN","25 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","BD ULTRA-FINE MICRO","","","Select","Select",""],["","","Potassium Cl","20 MEQ","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","HEALTHMART TRUE METRIX","","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","Select","Select",""],["","","Bd Ultra-Fine Nano (Ref 320122)","","","Select","Select",""],["","","METOPROLOL SUCC","50 MG","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","Dexcom G7 Receiver (Ref Stk-At-012)","","","Select","Select",""],["","","Insulin Glargine 100 Units\/Ml Inj (Pen) Wi","","","Select","Select",""],["","","TIZANIDINE","2 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","MECLIZINE","12.5 MG","","Select","Select",""],["","","Metformin 1","","","Select","Select",""],["","","DEXCOM G","7 RECEIVER","","Select","Select",""],["","","INSULIN GLARGINE","100 UNITS\/ML","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","CLOTRIMAZOLE","0.01","","Select","Select",""],["","","BD ULTRA-FINE NANO (REF","","","Select","Select",""],["","","EMBECTA NANO","2ND GEN","","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":""}]}]}