{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Dexter A Williams","gend":0,"currentgend":"","add":"22 GRIFFIN ST","city":"Gardiner","state":"ME","zip":"04345","dob":"1944-11-07","age":"","mstatus":"","insh":"00008037700","cliId":"","pno":2075824950,"cno":"","email":"declined@05222025.com","ename":"","eno":"","pphy":"MILLER, ROY S","ppno":2075497581,"pcpadd":"PO BOX 207,","pcpcity":"COOPERS MILLS","pcpstate":"ME","pcpzip":"43410207","pcpcounty":"","pcpid":"","pcpname":"SHEEPSCOT VALLEY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2075824950,"add2":"","add3":"","madd1":"22 GRIFFIN ST","madd2":"","madd3":"","mcity":"Gardiner","mstate":"ME","mzip":"04345","pcpfaxno":"","pcpnpi":1700854361,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4VW1C22YC37","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I4821","N320","E1151","S93401A","I2510","I10","I350","I1310","R932","R140","E7800","E1122","I129","N184","R809","D649","S99919A","W009XXA","S92341A","Z79899","R9720","Z794","B029","E782","E875","I6522","E119","M7731","M7661","M19071","R7309","N2581","Z0000","R600","J029"],"date":["2025-09-11","2024-10-21","2025-03-20","2025-02-27","2025-09-11","2025-09-11","2025-09-11","2025-01-07","2024-05-29","2024-05-29","2025-03-20","2024-10-30","2025-07-28","2025-07-28","2025-07-28","2025-07-28","2025-02-27","2025-02-27","2025-02-27","2024-02-26","2024-10-18","2023-03-14","2024-11-04","2023-08-22","2024-03-21","2023-02-14","2024-07-09","2025-02-27","2025-02-27","2025-02-27","2024-10-30","2024-06-28","2025-04-28","2023-08-11","2022-10-24"],"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":[["","","EZETIMIBE","","","Select","Select",""],["","","NOVOLIN N","","","Select","Select",""],["","","GLIPIZIDE","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","INSULIN SYRINGE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","TRUEPLUS INSULIN SYRINGE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ULTRA-FINE INSULIN SYRINGE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","FREESTYLE LIBRE 3 READER","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","LAGEVRIO (EUA)","","","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":{"indx":[],"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":""}]}]}