{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Norman L Miville","gend":0,"currentgend":"","add":"405 BRUNSWICK AVE","city":"Gardiner","state":"ME","zip":"04345","dob":"1943-02-02","age":"","mstatus":"","insh":"10000035909","cliId":"","pno":2074418344,"cno":"","email":"","ename":"","eno":"","pphy":"HOKE, ABIGAIL","ppno":2075826608,"pcpadd":"Gardiner Family Medicine,5 Central Maine Crossing","pcpcity":"Gardiner","pcpstate":"ME","pcpzip":"04345","pcpcounty":"","pcpid":"","pcpname":"GARDINER FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"405 BRUNSWICK AVE","madd2":"","madd3":"","mcity":"Gardiner","mstate":"ME","mzip":"04345","pcpfaxno":2075822258,"pcpnpi":1740576495,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3F38FR0HE45","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N200","H53122","B880","H04123","M79661","A4151","N390","I10","E785","K0889","K219","Z79899","L299","Z87891","H2513","H2511","N400","H2512","H26493","N201","N202","R109","R112","Z87442","N139","N2882","N281","R7881","N320","K5730","I749","K047","M47817","M5450","Z0000","Z125","Z0101","I739","I708","H40053","R1084","I82431","M7989","K1379","Z23","L570","Z961","I723","N2889","N261","R1111","R531","G3184","R0602","Z0100"],"date":["2024-07-18","2025-05-19","2025-05-19","2025-05-19","2024-09-06","2024-07-17","2024-08-16","2024-10-14","2025-11-11","2024-09-21","2024-08-28","2024-09-27","2024-08-28","2024-08-28","2024-02-01","2024-03-14","2024-07-23","2024-02-01","2025-04-30","2023-08-09","2023-08-02","2023-08-02","2023-08-02","2023-11-29","2023-07-26","2023-07-26","2024-11-19","2024-07-16","2024-07-18","2024-07-18","2024-09-27","2024-09-27","2023-02-14","2023-07-26","2025-05-14","2023-02-14","2024-01-15","2024-11-19","2024-09-10","2025-04-28","2023-07-26","2024-09-06","2024-09-06","2023-11-09","2023-11-09","2025-05-14","2024-02-02","2024-11-19","2024-11-19","2024-11-19","2024-07-15","2024-07-15","2022-10-11","2022-10-11","2022-09-29"],"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":[["","","ELIQUIS","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","CEFUROXIME","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PENICILLIN V POTASSIUM","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","MOMETASONE FUROATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","OXYCODONE 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":[]}},{"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":""}]}]}