{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Timothy A Clough","gend":0,"currentgend":"","add":"26 ROBINSON LN","city":"SOUTHWEST HARBOR","state":"ME","zip":"04679","dob":"1961-07-13","age":"","mstatus":"","insh":"10000008604","cliId":"","pno":2072443326,"cno":"","email":"taclough@roadrunner.com","ename":"","eno":"","pphy":"LAWSON, KATHERINE L","ppno":2072885024,"pcpadd":"10 WAYMAN LN,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46091625","pcpcounty":"","pcpid":"","pcpname":"COOPER GILMORE HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2072443326,"add2":"","add3":"","madd1":"PO BOX 422","madd2":"","madd3":"","mcity":"SOUTHWEST HARBOR","mstate":"ME","mzip":"04679","pcpfaxno":"","pcpnpi":1700018645,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5NR5JT2VF65","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G4733","Z45018","Z0000","E119","E785","F331","M25561","I498","E113393","H35033","H353130","H35363","R9431","H8110","M25361","R001","H401131","H43393","I10","E6601","J9811","J90","Z950","R0989","H353131","H538","F17210","I2510","R42","R1110","Z09","Z743","R112","I491","I495","I455","G894","Z01810","E1169","H25033","R0602","M546"],"date":["2025-08-11","2025-07-30","2024-11-15","2025-08-15","2024-07-10","2025-08-18","2024-03-28","2024-11-05","2025-03-06","2025-03-06","2025-03-06","2025-03-06","2024-07-12","2024-01-16","2024-03-28","2024-08-16","2025-06-18","2025-06-18","2025-04-24","2024-03-19","2024-10-26","2024-10-26","2024-10-26","2024-10-26","2022-10-24","2024-05-22","2024-07-10","2024-07-29","2023-07-06","2023-07-06","2024-11-08","2023-07-06","2023-07-06","2024-09-18","2024-10-25","2024-06-18","2023-10-23","2024-10-04","2025-06-13","2025-06-18","2024-10-10","2024-07-01"],"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":[["","","MECLIZINE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OXYCONTIN","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","RYBELSUS","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"comment":[["","","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}