{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lauretta A Froshour","gend":1,"currentgend":"","add":"695 BLACKSWOODS RD","city":"CHERRYFIELD","state":"ME","zip":"04622","dob":"1956-03-17","age":"","mstatus":"","insh":"10000098766","cliId":"","pno":"2075462250","cno":"","email":"declined@032725.com","ename":"","eno":"","pphy":"RAMSAY, DREW C","ppno":"2075462391","pcpadd":"Milbridge Medical Center,24 School St","pcpcity":"Milbridge","pcpstate":"ME","pcpzip":"04658","pcpcounty":"","pcpid":"","pcpname":"MILBRIDGE MEDICAL CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"695 BLACKSWOODS RD","madd2":"","madd3":"","mcity":"CHERRYFIELD","mstate":"ME","mzip":"04622","pcpfaxno":"","pcpnpi":"1720516248","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9EF1PK4WD95","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R0600","Z952","Z48812","G9389","Z8673","I340","R569","I110","I5032","I25810","I5033","I4891","I429","Z7901","Z79899","Z7982","I4821","I509","I2510","I480","Z955","Z0000","I10","E785","Z0189","Z0001","Z951","R9431","H6120","Z23","I82401","Z01812","N184","N1832","D649","N250","I4892","Z1231","M549","E119","E039","Z09","Q600","M21371","R42","R55","I349","Z8669","I129","I059","J90","J9811","I081","R0989","I63531","U071","E8720","Z95818","N179","E8770","R2242","Z01810","J8410","Z452"],"date":["2023-04-11","2025-08-07","2023-03-25","2023-11-24","2024-12-13","2023-05-01","2024-03-23","2024-02-27","2024-02-27","2023-04-25","2024-07-22","2026-01-21","2025-08-07","2023-11-22","2023-11-24","2024-12-13","2026-02-17","2025-03-14","2025-08-07","2024-07-22","2023-07-03","2025-07-17","2025-07-28","2024-07-16","2023-08-24","2023-07-11","2025-08-07","2023-11-22","2023-12-26","2024-01-04","2024-01-23","2024-02-19","2024-03-08","2025-07-28","2025-07-28","2025-07-28","2024-02-27","2024-10-09","2025-05-05","2025-09-25","2024-07-16","2024-12-13","2024-11-07","2025-12-02","2023-03-21","2023-03-21","2023-03-21","2024-12-13","2025-07-21","2023-03-17","2023-03-16","2023-03-16","2023-02-13","2023-02-07","2023-02-13","2023-02-13","2023-02-13","2023-02-16","2023-02-06","2023-02-06","2023-02-16","2023-01-31","2023-01-31","2023-02-01"],"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":[["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","VALSARTAN","40 MG","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","AMIODARONE","200 MG","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","ONETOUCH VERIO","","","Select","Select",""],["","","TRAZODONE","100 MG","","Select","Select",""],["","","LEVOTHYROXINE","150 MCG","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","Onetouch Ultra Blue","","","Select","Select",""],["","","GLIPIZIDE","5 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","Eliquis","","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","METOPROLOL SUCC","50 MG","","Select","Select",""],["","","Onetouch Ultra 2","","","Select","Select",""],["","","PHENYTOIN","100 MG","","Select","Select",""],["","","ONETOUCH DELICA","","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","METOPROLOL TART","25 MG","","Select","Select",""],["","","PREVNAR","","","Select","Select",""],["","","SPIKEVAX","","","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":""}]}]}