{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joan M Cannell","gend":1,"currentgend":"","add":"23 HICKORY LN","city":"Gorham","state":"ME","zip":"04038","dob":"1950-03-29","age":"","mstatus":"","insh":"10000039560","cliId":"","pno":"2076478416","cno":"","email":"declined@09272021.com","ename":"","eno":"","pphy":"JOLICOEUR, MYRIAM","ppno":"2076936106","pcpadd":"76 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407649","pcpcounty":"","pcpid":"","pcpname":"NAPLES FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"23 HICKORY LN","madd2":"","madd3":"","mcity":"Gorham","mstate":"ME","mzip":"04038","pcpfaxno":"2076934026","pcpnpi":"1316433667","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2W36D01UR84","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M810","Z1231","I10","G8911","I330","M4649","Z1509","N393","M25562","G8929","B9561","H8110","G061","Z1211","M4620","M25551","D649","R748","K769","A4901","R7881","M4643","R42","M47812","R52","R2689","Z743","R9402","R270","R1110","Z8542","F1090","R4189","E785","N281","K821","N261","R1013","K760","K828","E860","R4182","I38","B9562","Q2112","I3489","K2950","A4101","K5730","K219","A419","L539","D120","D122","K259","Z800","R5381","R7989","R9089","M4642","M4646","N390","M542","I080","I253","I77819","Z13820","R509","R1011","M6281","R262","B951","H6123","Z7189","T184XXA","Q239","M546","S199XXA","S0990XA","M5450","Z780","D124","R531","R7401","E806","R6510","D123","D125","Z87891","M5127","M47817","M4316","R112","Z23","R519","M5124","M5134","M50323","M4312","S39012A","M25559","M160","M47816","S3993XA","R1031","K429","Z0000"],"date":["2024-04-19","2024-05-17","2025-09-23","2025-09-22","2025-11-13","2025-10-14","2025-09-25","2025-09-25","2025-08-29","2025-08-29","2025-12-15","2025-07-16","2025-12-23","2025-11-03","2025-09-27","2025-09-18","2026-03-03","2026-03-03","2026-03-04","2025-08-05","2025-09-10","2025-08-07","2025-07-29","2025-09-27","2025-08-07","2026-02-06","2025-08-07","2025-07-27","2025-07-17","2025-07-16","2025-07-16","2025-09-22","2025-09-22","2025-09-23","2026-03-04","2026-03-02","2026-03-02","2026-03-02","2026-03-04","2026-03-02","2025-07-20","2025-07-29","2025-07-31","2025-07-31","2025-09-23","2025-07-31","2024-12-27","2025-07-20","2025-07-20","2025-09-23","2025-07-21","2026-01-03","2025-11-03","2025-11-03","2025-04-18","2024-09-27","2025-10-09","2026-03-02","2025-07-29","2025-07-29","2025-07-29","2025-07-29","2025-07-19","2025-09-23","2025-09-23","2025-09-23","2024-08-05","2026-03-03","2026-03-03","2026-02-06","2026-02-06","2025-10-09","2025-08-18","2025-09-08","2025-11-05","2025-11-13","2025-07-21","2025-07-19","2025-07-19","2025-07-21","2024-08-05","2025-11-03","2026-03-03","2026-03-03","2026-03-03","2026-03-03","2025-11-03","2025-11-03","2025-09-23","2025-09-27","2025-09-27","2025-09-27","2025-07-16","2025-10-02","2025-07-19","2025-09-27","2025-09-27","2025-09-27","2025-09-27","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-03-13","2023-02-09"],"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",""],["","","OSELTAMIVIR","75 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","NYSTOP","","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","Mirabegron","25 MG","","Select","Select",""],["","","MECLIZINE","25 MG","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","CEFADROXIL","1 GM","","Select","Select",""],["","","Ciprofloxacin 0.3 % Ophth Sol Sandoz","","","Select","Select",""],["","","CIPROFLOXACIN","0.003","","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":""}]}]}