{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard D Rideout","gend":0,"currentgend":"","add":"192 NORTH ST","city":"Bath","state":"ME","zip":"04530","dob":"1945-03-03","age":"","mstatus":"","insh":"10000020364","cliId":"","pno":2074432070,"cno":2073896035,"email":"","ename":"","eno":"","pphy":"CARDELLA, AMANDA D","ppno":2077984400,"pcpadd":"Martins Point Health Care,PO Box 9746","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04104","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"192 NORTH ST","madd2":"","madd3":"","mcity":"Bath","mstate":"ME","mzip":"04530","pcpfaxno":2077984018,"pcpnpi":1902219389,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2Y26E12WK59","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I7133","Z0000","I2510","K219","I10","I7140","E870","R001","Z4682","R1110","R918","I7130","J90","J811","D689","R0602","R531","R4182","J9811","R578","I361","Z9911","I959","A403","R079","E785","Z136","R1032","I209","I495","R0689","J984","M109","R7303","I7143","K5730","K828","J9601","M1811","M79621","R6339","U071","M1120","J1282","R000","R0682","A419","R933","N200","M79643","K567","K315","M11231","D75839","K683","K30","Z952","R109","R112","K2090","R683","M9900","M9901","M9902","M25531","N400","E46","Z743","Z4659","R911","J189","Z20822","R059","R5383","Z125","R55","J181"],"date":["2025-03-25","2023-12-11","2025-03-17","2025-03-17","2025-03-17","2025-02-03","2024-11-27","2024-11-27","2024-12-09","2024-12-10","2025-03-12","2024-11-15","2024-11-20","2024-11-20","2025-02-01","2025-02-05","2025-02-05","2025-01-18","2024-11-29","2024-11-16","2024-11-18","2024-11-18","2024-11-18","2025-02-05","2024-12-03","2024-12-18","2024-11-17","2024-11-15","2024-11-15","2024-11-17","2024-11-16","2024-11-17","2025-03-17","2023-09-01","2025-03-12","2025-03-12","2025-03-12","2025-02-19","2025-01-08","2025-01-09","2024-12-17","2025-02-19","2025-02-19","2025-02-19","2025-02-05","2025-02-05","2025-02-05","2024-12-10","2024-12-26","2025-01-09","2025-01-02","2024-12-18","2025-01-30","2025-01-30","2024-12-06","2024-12-06","2024-12-06","2024-12-30","2025-02-01","2024-12-18","2024-12-18","2025-01-16","2025-01-16","2025-01-16","2025-01-27","2025-01-27","2025-01-27","2025-01-18","2024-11-30","2022-11-09","2022-09-28","2022-09-28","2022-08-16","2022-08-16","2022-08-26","2022-08-16","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":[["","","OMEPRAZOLE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CEFDINIR","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}