{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kristen R Andersen","gend":1,"currentgend":"","add":"777 STURTEVANT HILL RD","city":"Winthrop","state":"ME","zip":"04364","dob":"1955-09-26","age":"","mstatus":"","insh":"10000091446","cliId":"","pno":"2079317770","cno":"","email":"andersen.kristen@gmail.com","ename":"","eno":"","pphy":"WOLFE, KAYLEE","ppno":"","pcpadd":"PO BOX 727,","pcpcity":"WATERVILLE","pcpstate":"ME","pcpzip":"49030727","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"777 STURTEVANT HILL RD","madd2":"","madd3":"","mcity":"Winthrop","mstate":"ME","mzip":"04364","pcpfaxno":"","pcpnpi":"1285364489","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1NG7XE5VP35","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":["C73","E890","Z79890","R944","Z85850","Z9089","R7989","E119","Z23","Z1329","Z1231","R918","Z0100","M47812","J341","I6523","S0502XA","R350","H1031","X58XXXA","R309","N1832","N1830"],"date":["2024-07-06","2024-05-23","2024-05-23","2023-05-22","2023-06-02","2023-06-02","2023-06-28","2024-05-10","2023-08-11","2023-08-08","2023-10-03","2024-03-20","2023-10-31","2023-10-24","2023-10-24","2023-10-24","2024-01-06","2024-01-08","2024-01-09","2024-01-06","2024-01-08","2024-06-27","2024-05-21"],"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",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","Fluad","","","Select","Select",""],["","","Simvastatin","40 MG","","Select","Select",""],["","","Bupropion Hcl","300 MG","","Select","Select",""],["","","Comirnaty","","","Select","Select",""],["","","Terbinafine","250 MG","","Select","Select",""],["","","Arexvy","","","Select","Select",""],["","","Boostrix","","","Select","Select",""],["","","Lisinopril","40 MG","","Select","Select",""],["","","Levothyroxine","112 MCG","","Select","Select",""],["","","Spikevax","","","Select","Select",""],["","","Freestyle Libre 14 Day Sensor (Ref 71940-0","","","Select","Select",""],["","","Ciprofloxacin 0.3 % Ophth Sol Leading Phar","","","Select","Select",""],["","","Omeprazole","20 MG","","Select","Select",""],["","","Bupropion Xl","","","Select","Select",""],["","","Jardiance","","","Select","Select",""],["","","Prevnar 20","","","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":""}]}]}