{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Karlene E Thompson","gend":1,"currentgend":"","add":"18 ANNIES WAY APT 19","city":"Standish","state":"ME","zip":"04084","dob":"1948-02-19","age":"","mstatus":"","insh":"10000050219","cliId":"","pno":"2072511258","cno":"","email":"adonai.david@gmail.com","ename":"","eno":"","pphy":"STEELE, ERIK N","ppno":"","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":"2072511258","add2":"","add3":"","madd1":"18 ANNIES WAY APT 19","madd2":"","madd3":"","mcity":"Standish","mstate":"ME","mzip":"04084","pcpfaxno":"2078287850","pcpnpi":"1538176789","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1EX8A91XX25","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":["E871","H348310","Z0101","I671","R6889","M25469","M11261","M1711","M7989","M25561","M7121","S79911A","S79921A","N3000","I129","N189","M25461","M660","I10","E222","M7051","M19031","M1811","E039","E785","E559","R197","I4710","D729","D72829","Z1231","J302","F10920","S51011A","Z48812","R262","M6281","Z96651","Z471","I724","K219","D509","M79604","F1010","W19XXXA","Z9011","T81718A","D649","R9089","R531","Z87891","Z98890","R350","G8918","R002","Z01818","Z01812","I6523","G9389","K5520","K5730","K222","K649","K449","S199XXA","S0990XA","M8588","L03113","N390","Z4682","E611","H5203","F419","R3911"],"date":["2025-12-17","2025-10-28","2025-05-05","2026-02-25","2023-06-22","2023-06-28","2024-03-18","2024-09-30","2023-07-10","2024-11-06","2024-07-13","2023-08-13","2023-08-13","2023-08-13","2023-08-13","2023-08-13","2024-11-06","2023-09-22","2025-12-17","2023-11-14","2024-01-11","2024-03-18","2024-03-18","2025-09-10","2025-05-15","2025-01-31","2024-04-17","2024-04-17","2024-04-17","2024-04-30","2025-05-01","2024-06-01","2024-07-13","2024-07-13","2025-08-23","2024-11-06","2024-11-06","2025-09-16","2025-09-16","2025-07-30","2025-07-17","2026-01-05","2025-07-19","2024-07-12","2024-07-12","2025-05-01","2025-07-30","2025-10-21","2025-05-15","2025-10-16","2025-10-16","2025-05-15","2024-12-19","2024-09-30","2025-10-15","2024-09-04","2024-08-29","2025-07-18","2025-07-18","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2025-11-26","2024-07-12","2024-07-12","2023-03-21","2024-07-19","2024-12-19","2025-07-18","2025-12-05","2025-05-05","2025-12-10","2023-02-08"],"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",""],["","","Triamcinolone Acet 0.1 % Dent Paste Taro","","","Select","Select",""],["","","PRASUGREL","10 MG","","Select","Select",""],["","","Lidocaine Viscous 2 % Oral Top Sol Advagen","","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","LEVOTHYROXINE","88 MCG","","Select","Select",""],["","","METOPROLOL SUCC","100 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","AMLODIPINE","2.5 MG","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","MELOXICAM","15 MG","","Select","Select",""],["","","SIMVASTATIN","10 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","LIDOCAINE VISCOUS","0.02","","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":""}]}]}