{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Craig Carscallen","gend":0,"currentgend":"","add":"19 RIVER RUN","city":"Lyman","state":"ME","zip":"04002","dob":"1946-09-24","age":"","mstatus":"","insh":"10000030286","cliId":"","pno":2074673125,"cno":"","email":"CCARSCALLEN@YAHOO.COM","ename":"","eno":"","pphy":"CROTHERS, DANIEL S","ppno":2078282402,"pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":5406865659,"add2":"","add3":"","madd1":"19 RIVER RUN","madd2":"","madd3":"","mcity":"Lyman","mstate":"ME","mzip":"04002","pcpfaxno":2078282433,"pcpnpi":1336601996,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4XV0HK9CH01","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C9110","M941","C61","R918","Z5111","Z86711","R079","D472","H61033","Z7952","R809","R6883","R0602","R5383","D5911","H6091","K8020","M6281","R530","H18453","R801","D649","E785","Z136","I2510","Z08","Z8546","Z923","Z5112","I10","N1831","Z1211","D124","D125","K5730","M25569","M79643","Z86010","K635","R7989","D699","Z510","R351","C44519","L821","R9341","Z23","L820","L578","Z85820","Z85828","I4430","R931","I440","I4510","M170","M11261","M11262","R3121","N390","R300","N1830","R310","I517","R791","I340","I77810","R1031","K8080","Z87891","R221","R051","N189","L570","L814","D492","N393","Z0101","H52223","H524","R059","Z125","K449","E041","K219","J8410","R911","R350","M25562","M25561","H6122","R739","N529","N486"],"date":["2025-09-24","2025-09-24","2025-09-25","2025-11-05","2023-11-01","2025-11-05","2025-11-10","2025-09-24","2025-06-23","2024-06-12","2025-11-19","2023-06-05","2025-07-10","2024-05-17","2025-09-24","2023-01-25","2025-10-31","2024-05-16","2024-05-16","2025-03-17","2025-03-31","2025-09-26","2025-11-10","2025-11-10","2025-11-10","2024-10-24","2024-10-24","2024-10-24","2023-11-29","2025-09-26","2025-11-19","2024-04-08","2024-04-08","2024-04-08","2024-04-08","2025-06-23","2025-06-23","2024-04-08","2024-04-08","2024-05-17","2023-05-25","2023-12-01","2023-07-28","2024-07-24","2025-02-05","2023-08-29","2025-10-03","2024-05-21","2025-08-06","2025-08-06","2025-08-06","2023-04-06","2023-04-06","2025-07-10","2025-07-10","2024-10-02","2024-10-02","2024-10-02","2023-01-26","2025-09-25","2025-11-19","2024-09-19","2025-08-15","2023-04-03","2023-04-03","2024-11-26","2024-11-26","2025-10-25","2025-10-25","2025-10-25","2025-10-23","2025-02-21","2023-01-26","2025-08-06","2025-08-06","2024-05-21","2025-09-25","2025-03-17","2025-03-17","2025-03-17","2024-02-16","2025-09-26","2023-09-11","2025-10-23","2023-04-03","2024-10-18","2024-10-18","2025-11-19","2024-10-02","2024-10-02","2022-11-02","2022-08-23","2022-09-08","2022-09-08"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","VENCLEXTA","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","VENCLEXTA STARTING PACK","","","Select","Select",""],["","","PROCHLORPERAZINE MALEATE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","CALQUENCE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","PAXLOVID (EUA)","","","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":""}]}]}