{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Edward Morse","gend":0,"currentgend":"","add":"7 GRAFFAM WAY","city":"Bath","state":"ME","zip":"04530","dob":"1944-08-11","age":"","mstatus":"","insh":"00008007700","cliId":"","pno":2074436455,"cno":"","email":"joyacadia@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 - 2025","region":"","aligned":"","ano":2074436455,"add2":"","add3":"","madd1":"7 GRAFFAM WAY","madd2":"","madd3":"","mcity":"Bath","mstate":"ME","mzip":"04530","pcpfaxno":2078287850,"pcpnpi":1538176789,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8AG2VP9XX11","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1832","N281","Z23","I87323","N1831","I10","N2581","G243","I129","M19041","I999","R809","I7120","I480","I420","H2513","H5213","Z98890","D649","N401","N1830","I340","I517","D2339","L989","Z9849","I4891","G248","R000","H25811","H2512","H04123","H25812","R002","J449","R4182","E785","W5501XA","I493","J45909","R6889","I4710","I4720","I498","H25813","I77810","K7689","R457"],"date":["2024-10-04","2023-11-30","2025-09-05","2023-04-19","2025-07-22","2025-07-22","2025-07-22","2025-03-31","2024-06-04","2024-06-04","2022-11-30","2023-02-24","2025-07-03","2025-07-02","2025-07-02","2024-01-10","2023-11-14","2024-11-14","2022-10-03","2023-10-04","2022-10-03","2024-11-14","2022-10-04","2023-10-31","2023-11-07","2024-02-16","2024-11-04","2023-11-29","2023-01-19","2023-12-20","2024-01-10","2025-03-27","2024-01-10","2022-12-23","2024-01-10","2023-12-20","2024-01-10","2024-01-16","2024-11-15","2024-01-10","2023-05-18","2024-11-15","2024-11-15","2024-11-15","2023-03-31","2024-12-08","2024-12-08","2022-09-23"],"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":[["","","BACLOFEN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CARBIDOPA-LEVODOPA","","","Select","Select",""],["","","LABETALOL HCL","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","MUPIROCIN","","","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":""}]}]}