{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Arthur N Robbins","gend":0,"currentgend":"","add":"28 KEITH ST","city":"Livermore","state":"ME","zip":"04253","dob":"1946-11-27","age":"","mstatus":"","insh":"10000030751","cliId":"","pno":2078970941,"cno":2074851551,"email":"art_robbins@yahoo.com","ename":"","eno":"","pphy":"THORP, LYDIA A","ppno":2075243501,"pcpadd":"180 CHURCH HILL RD STE 1,","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"28 KEITH ST","madd2":"","madd3":"","mcity":"Livermore","mstate":"ME","mzip":"04253","pcpfaxno":2075242093,"pcpnpi":1801875018,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6R42CA7HU28","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1121","Z95810","R9439","E119","T827XXD","I350","I4720","E118","E113293","I428","I480","E782","E039","I509","Z23","I4821","Z950","U071","R059","R079","E875","I7143","I708","I080","I5021","I2510","I25810","I420","R6889","S30860A","I517","I442","K219","J45909","Z713","I459","I088","I083","Z959","T82190A","I5189","I7133","I25112","I10","R200","M109","I7140","Z7901","R0602","Z45010","I25118","E7849","M009","M25471","M00871","M19071","D72829","E1169","L03115","I4891","M869","M25461","M7989","M00879","M25572","Z794","I5023","Z4502","I110","I5022","I255","Z01818"],"date":["2025-04-28","2025-10-03","2025-06-23","2025-11-07","2025-09-23","2024-09-09","2024-03-18","2025-10-02","2025-10-02","2025-07-14","2023-12-05","2023-10-19","2025-07-28","2025-10-01","2025-10-23","2025-10-14","2025-11-07","2024-02-02","2024-02-02","2025-06-18","2022-12-21","2024-04-24","2024-04-24","2025-06-20","2025-06-20","2025-06-23","2025-06-23","2024-08-06","2023-01-11","2025-05-27","2024-08-06","2025-11-07","2025-11-07","2025-11-07","2022-12-19","2025-11-07","2023-12-05","2025-04-22","2025-04-22","2025-11-07","2022-12-20","2023-11-27","2025-06-23","2025-06-23","2024-11-07","2022-12-21","2024-04-24","2023-10-23","2025-06-20","2022-11-25","2022-11-25","2022-11-25","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-08","2022-11-05","2022-11-07","2022-11-08","2022-11-07","2022-11-07","2022-11-22","2022-11-07","2022-11-07","2022-09-09","2022-08-16","2022-08-16","2022-08-16","2022-08-15","2022-08-12"],"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":[["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","BASAGLAR KWIKPEN U-100","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","RYBELSUS","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ULTRA-FINE MINI PEN NEEDLE","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ADACEL TDAP","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)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":{"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":""}]}]}