{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Patricia A Levesque","gend":1,"currentgend":"","add":"20 KING ST","city":"SPRINGVALE","state":"ME","zip":"04083","dob":"1946-11-02","age":"","mstatus":"","insh":"10000092376","cliId":"","pno":"2074903841","cno":"","email":"richanda65@gmail.com","ename":"","eno":"","pphy":"MALONSO, RESTITUTO D","ppno":"6036096800","pcpadd":"Strafford Medical Associates,10 Members Way Ste 500","pcpcity":"Dover","pcpstate":"NH","pcpzip":"03820","pcpcounty":"","pcpid":"","pcpname":"WHP INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2076085564","add2":"","add3":"","madd1":"20 KING ST","madd2":"","madd3":"","mcity":"SPRINGVALE","mstate":"ME","mzip":"04083","pcpfaxno":"","pcpnpi":"1760470975","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3DY0QN5VF22","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I7782","E119","R791","E039","H532","M6281","R296","R2681","R2689","N3000","W19XXXA","I10","S4991XA","R0781","S0990XA","M25511","I129","E1122","N390","K219","N189","G4733","D509","R29898","N1832","E871","N179","M310","R768","Z9181","K9089","D631","D6861","Z712","Z7189","D508","R300","Z86711","M79605","S299XXA","S199XXA","G319","M5030","G9341","U071","R531","T148XXA","R5381","R509","R002","W19XXXD","A419","R350","Z7901","H6123","N1830","M159","D638","D500","R4182","N3001","M5416","Z0101","M48061","M5136","M47816","Z743","D689","N184","F32A","E1365","I130","Z87440","E1121","F03A3","D334","D61818","N200","S79911A","Z79899","D119","L602","R918","S42201A","G9340","A4151","R1031","Z23","R059","R051","Z03818","G8929","G3184","S42291A","R410","B999","K6289","M4312","F02A3","I4821","R278","R4189","I2699","I4820","E785","Z0000","I6523","I080","I5030","G9389","R262","R479","R401","R270","R413","R5383","S3991XA","S3993XA","R21","E559"],"date":["2023-06-09","2026-01-28","2023-08-28","2026-01-21","2023-05-23","2026-01-05","2025-03-04","2024-11-20","2025-08-04","2026-02-03","2025-11-15","2026-01-21","2024-09-11","2023-07-03","2025-02-15","2023-07-03","2025-02-18","2025-02-18","2026-02-11","2023-11-30","2025-07-30","2025-03-07","2024-08-30","2023-07-26","2025-12-03","2023-08-01","2026-01-28","2023-08-17","2023-08-17","2023-08-28","2023-08-28","2024-10-18","2026-01-19","2024-06-24","2024-06-24","2024-07-26","2025-12-01","2025-10-06","2023-11-21","2023-11-19","2025-02-15","2024-11-20","2023-11-20","2026-02-11","2023-12-29","2025-11-17","2023-11-19","2025-11-15","2025-12-26","2024-01-30","2023-12-29","2025-12-25","2024-01-11","2025-11-15","2025-03-17","2026-03-02","2024-03-28","2025-12-15","2026-01-22","2026-02-03","2026-02-03","2024-11-26","2025-09-23","2023-03-25","2023-03-25","2023-03-25","2026-02-03","2023-03-31","2026-02-11","2026-01-21","2025-10-22","2026-01-19","2026-01-19","2025-12-29","2026-02-11","2024-07-19","2026-01-14","2024-07-27","2024-09-11","2024-10-18","2025-10-01","2026-01-02","2026-01-30","2024-09-11","2026-01-30","2025-12-25","2024-07-27","2024-10-07","2025-10-01","2025-09-29","2025-10-01","2024-10-27","2025-04-07","2024-09-11","2024-07-30","2025-08-31","2025-09-03","2025-12-25","2025-05-09","2025-03-08","2025-03-01","2024-11-20","2024-12-12","2025-03-01","2025-05-09","2025-03-15","2025-02-17","2025-02-17","2025-02-17","2025-04-04","2025-04-09","2025-04-09","2024-11-15","2025-04-04","2025-04-04","2024-12-09","2024-12-06","2024-12-06","2023-02-01","2023-01-18"],"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":[["","","Lantus","","","Select","Select",""],["","","HYDROXYZINE PAM","25 MG","","Select","Select",""],["","","Mupirocin 2 % Ointment Teva","","","Select","Select",""],["","","WARFARIN","6 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","Oxycodone Hcl","5 MG","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","GLIMEPIRIDE","1 MG","","Select","Select",""],["","","VENLAFAXINE","100 MG","","Select","Select",""],["","","HYDRALAZINE","25 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","ENOXAPARIN PF","80 MG\/0.8","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","DAPAGLIFLOZIN","5 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","ESTRADIOL","0.0001","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","ATORVASTATIN","20 MG","","Select","Select",""],["","","CEFPODOXIME","100 MG","","Select","Select",""],["","","Fosfomycin","3 GM","","Select","Select",""],["","","LEVOTHYROXINE","125 MCG","","Select","Select",""],["","","CEPHALEXIN","250 MG","","Select","Select",""],["","","Novolog Flexpen","","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","SERTRALINE","25 MG","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","HYDRALAZINE HCL","","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","TRESIBA","","","Select","Select",""],["","","LOSARTAN","50 MG","","Select","Select",""],["","","LANSOPRAZOLE","30 MG","","Select","Select",""],["","","METHENAMINE HIP","1 GM","","Select","Select",""],["","","Estradiol 0.01 % Vag Cream Prasco","","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","CIPROFLOXACIN","250 MG","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","FARXIGA","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","Metformin 1","","","Select","Select",""],["","","METFORMIN","","","Select","Select",""],["","","MUPIROCIN","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":""}]}]}