{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David L Hannan","gend":0,"currentgend":"","add":"83 PLYMOUTH RD","city":"CARMEL","state":"ME","zip":"04419","dob":"1948-04-06","age":"","mstatus":"","insh":"10000025928","cliId":"","pno":2078485244,"cno":"","email":"davidhannan19@yahoo.com","ename":"","eno":"","pphy":"CAMERON, DARLA N","ppno":2078620300,"pcpadd":"C\/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT,PO BOX 7291","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"83 PLYMOUTH RD","madd2":"","madd3":"","mcity":"CARMEL","mstate":"ME","mzip":"04419","pcpfaxno":2079071041,"pcpnpi":1639188758,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3UY9P29RQ29","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M47816","E782","I10","H9011","J189","H2511","J8410","H2512","E875","Z08","Z85118","J439","J449","I7389","Z98890","I493","I491","I4720","R911","K8020","N281","Z8673","C3411","I7143","Z87891","J984","H2513","R051","F17210","H9193","C3490","E785","H35371","Z0101","Z0000","Z79899","N400","G8929","I350","I6782","N401","I77810","F17200","J479","R918","S0501XA","K5900","I639","I6381","J441","I6523","E8342","J432","E278","K429","R0602","I6522","I739","Z95820","Z7982","J069","Z20822","H1130","I6503","R1032","I999","I6529","Z1159","I714","Z902"],"date":["2024-07-30","2025-08-05","2025-08-13","2023-12-18","2023-12-26","2024-01-15","2025-10-17","2024-01-29","2023-12-15","2025-07-16","2025-08-28","2025-08-13","2024-08-16","2025-01-29","2025-02-05","2023-09-22","2023-09-22","2023-09-22","2023-09-26","2025-08-28","2025-08-28","2025-07-16","2024-07-19","2025-01-03","2025-05-13","2025-08-28","2023-11-07","2023-11-20","2024-05-21","2023-10-10","2025-08-28","2023-08-29","2025-10-02","2025-10-02","2025-08-13","2025-02-03","2023-09-14","2023-08-01","2024-05-20","2025-01-03","2024-08-12","2023-08-17","2025-07-16","2025-08-28","2023-01-12","2025-06-25","2025-05-13","2023-07-14","2023-07-06","2025-05-13","2025-09-09","2023-05-18","2023-06-26","2023-06-26","2023-06-26","2025-05-13","2023-07-03","2022-12-07","2022-12-07","2022-12-07","2023-01-12","2023-01-12","2025-06-24","2023-06-27","2025-05-13","2023-06-27","2023-06-27","2022-09-19","2022-08-23","2022-08-23"],"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":[["","","CLOPIDOGREL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","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":""}]}]}