{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Myron N Bates","gend":0,"currentgend":"","add":"11 OLD CANNON ROAD","city":"BENEDICTA","state":"ME","zip":"04733","dob":"1942-06-17","age":"","mstatus":"","insh":"10000014225","cliId":"","pno":2073657445,"cno":2075215276,"email":"","ename":"","eno":"","pphy":"HRYNICK, MARTIN J","ppno":2073654335,"pcpadd":"PO Box 1820,","pcpcity":"Presque Isle","pcpstate":"ME","pcpzip":"04769","pcpcounty":"","pcpid":"","pcpname":"NORTH WOODS GENERAL PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 66","madd2":"","madd3":"","mcity":"BENEDICTA","mstate":"ME","mzip":"04733","pcpfaxno":2073654336,"pcpnpi":1790871648,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8YK0U52PV03","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32A","F419","L918","I4891","U071","M1612","G5601","E041","M25511","M542","Z45018","H2511","Z20828","Z743","M461","G5603","G5622","Z98890","Z0100","M948X8","L570","H2512","R319","R82998","H2513","R0602","R5383","I517","I2510","M533","Z48811","I480","M25552","H6120","E785","N401","I495","Q2112","H353130","R8281","Q245","M5450","M25551","L989","M25559","G5600","M79603","M549","N200","N281","H61009","Z0189","S40861A","W57XXXA","A6920","I4892","I10","Z23","R202","I259","R079","H353131","H338","H4322","J988","R059","R0989","E042"],"date":["2023-07-11","2023-12-06","2023-07-11","2024-12-23","2023-10-11","2024-03-27","2023-08-30","2022-11-30","2022-11-30","2022-12-12","2025-11-11","2025-07-22","2023-10-11","2023-10-11","2024-07-31","2023-07-03","2023-07-03","2023-02-08","2024-07-11","2024-01-11","2025-10-16","2025-08-05","2024-03-29","2024-03-29","2025-01-09","2023-03-15","2023-02-13","2023-02-13","2025-06-10","2024-06-28","2023-09-22","2023-12-22","2024-03-27","2025-10-16","2023-04-19","2024-07-17","2022-12-30","2022-11-28","2025-01-09","2024-03-27","2023-04-19","2023-12-06","2023-12-06","2023-12-06","2022-12-12","2023-02-14","2022-12-12","2024-08-30","2024-03-27","2024-03-27","2024-04-18","2025-04-18","2023-04-23","2023-04-23","2023-04-28","2023-12-22","2023-12-22","2022-09-30","2022-08-24","2022-08-24","2022-08-24","2022-07-07","2022-07-07","2022-07-07","2022-06-21","2022-06-21","2022-06-21","2022-06-16"],"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":[["","","FLUAD 2025-2026","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","SOTALOL","","","Select","Select",""],["","","TERAZOSIN HCL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","SERTRALINE HCL","","","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":""}]}]}