{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sandra H Dudley","gend":1,"currentgend":"","add":"50 FOOTE ST","city":"Old Orchard Beach","state":"ME","zip":"04064","dob":"1947-04-24","age":"","mstatus":"","insh":"10000039742","cliId":"","pno":"2074233249","cno":"","email":"sdudley7259@yahoo.com","ename":"","eno":"","pphy":"NORMAN, ANASTASIA R","ppno":"","pcpadd":"96 OCEAN ST STE 4,","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41062855","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"50 FOOTE ST","madd2":"","madd3":"","mcity":"Old Orchard Beach","mstate":"ME","mzip":"04064","pcpfaxno":"","pcpnpi":"1073833703","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9C06GK5JM40","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":["R059","E039","Z13228","E785","Z1231","H903","Z0100","G40109","Z1211","R195","K635","K5730","D120","D123","R918","J441","M48062","M5451","J181","R946","Z0000","R0609","R891","E041","I2510","E042","I083","L989","Z79890","J4550","J479"],"date":["2024-04-08","2024-06-17","2023-04-28","2023-04-28","2023-08-07","2023-08-11","2023-09-27","2023-10-02","2023-10-18","2023-10-18","2023-10-18","2023-10-18","2023-10-18","2023-10-18","2024-07-10","2024-02-02","2024-04-09","2024-04-09","2024-03-18","2024-05-24","2024-04-08","2024-07-10","2024-04-22","2024-05-15","2024-04-22","2024-06-17","2024-05-14","2024-05-29","2024-06-17","2024-07-10","2024-07-10"],"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":[["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","Lorazepam","1 MG","","Select","Select",""],["","","Mupirocin 2 % Ointment Padagis","","","Select","Select",""],["","","Fluzone High-Dose","","","Select","Select",""],["","","Breo Ellipta","","","Select","Select",""],["","","Cyclobenzaprine","5 MG","","Select","Select",""],["","","Albuterol Hfa","90 MCG","","Select","Select",""],["","","Lamotrigine","150 MG","","Select","Select",""],["","","Levothyroxine","100 MCG","","Select","Select",""],["","","Prednisone","20 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","Liothyronine","5 MCG","","Select","Select",""],["","","Azithromycin","250 MG","","Select","Select",""],["","","Fluzone High Dose","","","Select","Select",""],["","","Fluoxetine","20 MG","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Doxazosin","2 MG","","Select","Select",""],["","","Amoxicillin\/Clav","875\/125 MG","","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":""}]}]}