{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Pamela A Smith","gend":1,"currentgend":"","add":"135 SIDNEY BLVD","city":"HAMPDEN","state":"ME","zip":"04444","dob":"1956-01-23","age":"","mstatus":"","insh":"10000080683","cliId":"","pno":"2072175891","cno":"2072175891","email":"pamsmith.bodyvi@gmail.com","ename":"","eno":"","pphy":"PATTEN, JOHN L","ppno":"2078620300","pcpadd":"St Joseph Family Medicine Hampden,21 Western Ave","pcpcity":"Hampden","pcpstate":"ME","pcpzip":"04444","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"135 SIDNEY BLVD.","madd2":"","madd3":"","mcity":"HAMPDEN","mstate":"ME","mzip":"04444","pcpfaxno":"2077778800","pcpnpi":"1669577938","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8X37MY9TD34","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C50911","C773","Z170","Z79811","R300","R350","R229","C44619","D485","Z85828","Z85820","M8588","Z13820","Z1231","M25551","R2689","C50511","M25561","Z0000","M1712","M1711","M1611","M170","R232","Z9289","N952","C50111","R87619","H01002","H01005","H04123","Z124","D229","Z0101","H0288A","H0288B","H5213","H52223","H524","J40","S2232XA","M546","Z853","S2232XD","X58XXXA","R059","Z483","Z01818","Z471","C50919","C50812","Z96641","H43813","R928","Z96652","R0602","C50912","Z5111","M25562","D860","N6325","J984","D869","R600","Z9981","C50012","Z171","Z1722","Z1732","N649","K1230","M2550","R6889","C50112","Z01812","Z452","J702","I890","J189","J849","L600","E6609","R911","R590","I491","Z09","Z803","Z800","D4862","T451X5A","J069","R918","R0902","Q828","Z79899","Z1211","Z1212","Z86010","K5730","D692"],"date":["2025-03-12","2024-11-27","2024-12-10","2025-11-14","2023-05-12","2023-05-11","2023-07-12","2023-08-31","2024-07-05","2025-11-17","2025-11-17","2023-09-06","2023-09-06","2024-11-08","2024-11-26","2024-01-05","2024-01-05","2024-01-05","2025-06-26","2026-01-14","2023-12-07","2024-09-11","2023-12-07","2025-11-14","2023-12-29","2023-12-29","2023-12-29","2023-12-29","2024-02-01","2024-02-01","2024-03-28","2023-12-29","2025-11-17","2025-04-10","2024-05-30","2024-05-30","2025-04-10","2025-04-10","2025-04-10","2024-05-23","2024-06-30","2024-06-30","2024-12-18","2024-07-02","2024-06-30","2024-07-02","2025-01-20","2026-01-05","2026-01-28","2025-11-14","2024-12-20","2025-12-09","2023-03-27","2024-11-21","2026-03-06","2025-03-23","2025-11-14","2025-02-13","2026-03-06","2025-12-23","2024-11-14","2025-12-12","2025-12-15","2025-07-01","2025-03-26","2024-12-20","2024-12-20","2024-12-20","2024-12-20","2024-12-17","2025-02-13","2025-02-13","2023-03-27","2024-12-20","2026-01-05","2025-05-01","2025-03-19","2025-08-12","2025-03-23","2025-04-07","2025-07-14","2025-12-15","2024-08-13","2024-08-13","2026-01-15","2025-03-31","2024-12-18","2024-12-18","2024-11-21","2025-04-02","2026-01-02","2025-05-20","2025-03-19","2025-04-17","2025-10-30","2023-03-14","2023-03-14","2023-03-14","2023-03-14","2023-02-28"],"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":[["","","FLUCONAZOLE","150 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","LOTEMAX SM","","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","EXEMESTANE","25 MG","","Select","Select",""],["","","MIEBO","","","Select","Select",""],["","","CAPVAXIVE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Encube","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","ONDANSETRON","8 MG","","Select","Select",""],["","","FLUTICASONE PROP\/SALMETEROL","250\/50 MCG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","DEXAMETHASONE","4 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","Adacel","","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","HYOSCYAMINE","0.125 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","CELECOXIB","100 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","OXYBUTYNIN","5 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","ANASTROZOLE","1 MG","","Select","Select",""],["","","PROCHLORPERAZINE","10 MG","","Select","Select",""],["","","CYCLOBENZAPRINE","10 MG","","Select","Select",""],["","","Lidocaine Viscous 2 % Oral Top Sol Morton","","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Taro","","","Select","Select",""],["","","METHOCARBAMOL","750 MG","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","FAMOTIDINE","20 MG","","Select","Select",""],["","","Lidocaine Viscous 2 % Oral Top Sol West-Wa","","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","FLUTICASONE FUR\/VILANTEROL","200\/25 MCG","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","PREVNAR","","","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":""}]}]}