{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Donald E Miller","gend":0,"currentgend":"","add":"252 CHURCH RD","city":"Readfield","state":"ME","zip":"04355","dob":"1945-12-14","age":"","mstatus":"","insh":"00008765600","cliId":"","pno":2075120884,"cno":"","email":"DNMILLER55340@spectrum.net","ename":"","eno":"","pphy":"BROWN, BENJAMIN M","ppno":2073772111,"pcpadd":"Winthrop Family Medicine,16 Commerce Plaza Ste 3A","pcpcity":"Winthrop","pcpstate":"ME","pcpzip":"04364","pcpcounty":"","pcpid":"","pcpname":"WINTHROP FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2076859269,"add2":"","add3":"","madd1":"PO BOX 117","madd2":"","madd3":"","mcity":"Readfield","mstate":"ME","mzip":"04355","pcpfaxno":2076243845,"pcpnpi":1235216094,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4KM6UK2KU53","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R251","R531","I69220","J209","J4520","I4819","G8191","M25512","M19012","E1165","E1140","E0842","G3184","R32","H905","I495","Z0101","Z45018","Z09","I4891","Z79899","Z950","I6200","Z0000","S065X0D","Z0001","Z125","S70361A","W57XXXA","E1142","R569","S065XAA","R6889","Z794","G9389","R5383","G319","R1110","Z98890","I639","I480","E1151","R350","Z87440","G40909","S299XXA","Z48811","S199XXA","S3993XA","E119","Z7984","R42","Z95818","Z8679","X58XXXA","I10","E871","Z7901","S065XAD","R4701","R41840","R4189","I4821","I618","R4182","B351","L602","M79674","M79675","S06A0XA","M7582","G8929","S90464A","F32A","F419","N400","G4700","R059","R519","Z920","Z743","I63511","L989","R600","R942","R259","J9811","R631","R52","Z1211","D123","D6869","R001","E785","K635","K648"],"date":["2025-06-20","2025-06-20","2023-08-10","2025-07-16","2025-07-16","2025-05-02","2023-07-03","2024-10-28","2024-12-20","2024-10-28","2025-10-21","2023-02-02","2025-05-14","2023-02-02","2023-02-02","2024-12-02","2024-11-14","2025-10-17","2024-12-16","2025-07-28","2025-07-28","2025-07-28","2023-06-21","2025-11-05","2023-06-02","2024-10-30","2023-01-03","2025-04-21","2025-04-21","2024-02-07","2023-10-10","2023-10-10","2023-07-19","2025-05-14","2024-04-25","2023-06-08","2023-06-08","2023-06-03","2024-11-25","2023-06-01","2024-11-20","2024-04-24","2022-11-30","2022-11-30","2025-06-26","2023-06-02","2024-02-19","2023-06-02","2023-06-02","2024-04-29","2023-01-05","2023-06-28","2024-08-01","2023-10-12","2023-06-02","2024-02-07","2023-06-15","2023-06-15","2023-06-16","2023-06-16","2023-06-16","2025-05-19","2025-11-04","2024-04-25","2023-06-01","2023-01-19","2023-06-29","2023-01-19","2023-01-19","2023-06-05","2024-02-20","2024-02-20","2023-07-26","2023-07-03","2023-07-03","2023-07-24","2023-07-24","2025-03-17","2023-06-15","2024-12-02","2023-06-01","2023-06-15","2023-06-29","2023-06-29","2025-03-17","2025-06-03","2024-12-03","2022-11-19","2022-11-19","2022-11-04","2022-11-04","2022-11-19","2022-10-31","2022-11-02","2022-11-04","2022-11-04"],"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":[["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","JANUMET","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","FLECAINIDE ACETATE","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 READER","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","LOVASTATIN","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","CEFUROXIME","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","PLENVU","","","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":""}]}]}