{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Timothy A Taylor","gend":0,"currentgend":"","add":"5 BIRCH WAY","city":"Northeast Harbor","state":"ME","zip":"04662","dob":"1941-05-10","age":"","mstatus":"","insh":"00008195200","cliId":"","pno":2072763998,"cno":"","email":"","ename":"","eno":"","pphy":"PLOURDE, GABRIEL J","ppno":2072885119,"pcpadd":"Cadillac Family Practice,322 Main St","pcpcity":"Bar Harbor","pcpstate":"ME","pcpzip":"04609","pcpcounty":"","pcpid":"","pcpname":"CADILLAC FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2072763998,"add2":"","add3":"","madd1":"PO BOX 76","madd2":"","madd3":"","mcity":"Northeast Harbor","mstate":"ME","mzip":"04662","pcpfaxno":2078015801,"pcpnpi":1235525759,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6DF5KX5DU68","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M5412","D485","L814","L821","L578","H40013","H35373","H43393","H26493","H10533","H538","K2970","R109","K5730","E785","H35363","H43823","H34823","Z0000","I10","M109","B3789","G4733","J45909","N3281","K529","R143","M62838","M9903","M48061","M5459","R229","M25511","R1031","R110","R350","D225","S30861A","H401131","H35033","K4090","M542","N2889","D72821","Z23","N401","R0600","R058","S0502XA","L570","H4010X1","H04123","D2361","R3915","M50322","M4802","R1909","J189","R509"],"date":["2023-04-21","2025-07-14","2025-07-14","2025-07-14","2025-07-14","2024-07-08","2025-08-28","2025-08-18","2025-08-18","2024-10-16","2024-10-16","2024-03-21","2024-02-15","2022-12-12","2024-02-12","2025-08-28","2025-08-28","2025-08-28","2024-11-25","2025-05-28","2024-02-12","2022-10-13","2025-08-14","2023-08-31","2024-01-17","2024-09-20","2024-03-20","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2023-06-29","2023-06-29","2024-03-25","2024-03-25","2023-12-27","2025-04-16","2023-08-07","2025-08-18","2025-08-18","2024-02-09","2023-08-09","2024-01-08","2024-03-25","2023-10-03","2024-05-03","2023-11-27","2024-05-15","2024-04-26","2025-07-14","2025-01-21","2025-01-21","2023-07-14","2024-01-08","2023-04-21","2023-04-21","2024-02-15","2022-08-23","2022-08-18"],"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":[["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","BETHANECHOL CHLORIDE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","IPRATROPIUM-ALBUTEROL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","MYRBETRIQ","","","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":""}]}]}