{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Charles D Mcwilliams","gend":0,"currentgend":"","add":"27 ATWOOD LN","city":"PHIPPSBURG","state":"ME","zip":"04562","dob":"1949-07-08","age":"","mstatus":"","insh":"10000033978","cliId":"","pno":2072337073,"cno":"","email":"Mcwilliamscharles301@outlook.com","ename":"","eno":"","pphy":"SHEPHERD, AMBER","ppno":2077984400,"pcpadd":"Sheepscot Valley Health Center,114 Bath Rd","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"27 ATWOOD LN","madd2":"","madd3":"","mcity":"PHIPPSBURG","mstate":"ME","mzip":"04562","pcpfaxno":"","pcpnpi":1477941425,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4PE1J60DA32","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M160","M7061","M47896","N1830","M67813","F4323","H2512","R531","H538","I639","M25551","M25552","Z789","R262","I10","G20","G319","R9082","H532","M7521","Z98890","G20C","R29810","I672","Z23","N1832","Z8673","M1611","F419","E7800","N179","E538","R413","R739","G20A1","Z95818","R112","I6381","N1831","L570","Z125","I6329","A419","I69392","I4581","R1032","H2511","R9089","H7092","M1612","M25651","M65341","W19XXXA","H35371","H2513","H938X1","M26609","H903","M25652","R42","G936","J320","I69322","I739","N2581","R110","R1084","E785","H25811","F0631","Z79899","R1310","K5732","R935","N400","N189","E839","Z0389","K219","I358","I77810","I517","I129","I499","R918","R0989","J929","I083","I5040","R109","R10819","H6980","H25812","H26493","H5203","I491","I459","I4710","R1312","I351","Z131","M5136","M5450","R1031","K5790","K4090"],"date":["2025-08-12","2025-08-12","2025-08-12","2025-08-12","2023-07-17","2024-09-11","2024-05-21","2025-07-26","2025-08-15","2025-05-01","2025-03-19","2025-03-19","2025-08-05","2025-08-05","2025-08-29","2023-09-22","2025-05-01","2025-05-01","2025-05-03","2022-10-14","2023-07-17","2024-01-17","2024-12-16","2024-12-16","2024-10-04","2025-08-29","2025-08-14","2024-10-24","2023-04-12","2025-07-16","2025-07-28","2024-10-21","2025-05-14","2024-10-21","2025-08-14","2025-09-12","2024-11-07","2024-12-21","2024-01-26","2024-10-08","2024-08-24","2025-05-15","2024-10-27","2025-06-13","2024-10-26","2024-11-07","2024-05-28","2025-05-02","2024-12-16","2024-10-24","2024-11-25","2023-11-30","2025-07-25","2025-09-03","2024-01-24","2023-09-01","2023-09-01","2023-09-01","2024-11-25","2025-05-03","2025-05-02","2025-05-02","2025-01-20","2024-11-19","2025-08-29","2024-10-26","2024-10-26","2025-05-13","2023-08-23","2025-02-26","2023-07-28","2025-02-28","2024-11-07","2024-11-07","2024-11-07","2025-02-14","2025-02-14","2023-01-30","2024-12-18","2025-05-03","2025-05-02","2025-05-03","2025-05-01","2025-07-26","2024-10-26","2024-10-26","2024-10-26","2025-05-02","2025-05-02","2024-10-26","2024-10-26","2024-07-12","2022-12-08","2025-09-03","2025-09-03","2025-05-06","2025-05-06","2025-05-06","2025-02-28","2025-05-03","2023-08-01","2022-09-08","2022-09-08","2022-09-08","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":[["","","CLOPIDOGREL","","","Select","Select",""],["","","LOSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","TROSPIUM CHLORIDE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","DONEPEZIL HCL","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","FLUZONE TRIVALENT 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CARBIDOPA-LEVODOPA ER","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","CARBIDOPA-LEVODOPA","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","SELEGILINE 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":{"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":""}]}]}