{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Larry Dwyer","gend":0,"currentgend":"","add":"149 WARD HILL RD","city":"MADISON","state":"ME","zip":"04950","dob":"1949-10-31","age":"","mstatus":"","insh":"10000035956","cliId":"","pno":2073997202,"cno":"","email":"ldwyer149@gmail.com","ename":"","eno":"","pphy":"MALYK, TIMOTHY C","ppno":2074743320,"pcpadd":"Redington Family Practice,46 Fairview Ave Ste 111","pcpcity":"Skowhegan","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"REDINGTON FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"149 WARD HILL RD","madd2":"","madd3":"","mcity":"MADISON","mstate":"ME","mzip":"04950","pcpfaxno":2074749261,"pcpnpi":1225035512,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8X78XK2ME29","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I5022","L820","I110","L570","D485","Z0100","Z0000","Z4502","I255","I951","I513","L438","L821","J3489","I2510","I5020","I429","R6889","R350","I340","R351","C44529","I428","Z23","J343","J342","I77819","I509","E039","D045","R42","I77810"],"date":["2024-07-25","2025-06-17","2025-05-19","2025-06-17","2025-06-17","2025-04-25","2025-07-10","2025-08-20","2024-11-25","2025-03-25","2023-05-15","2024-12-03","2024-12-03","2023-05-25","2025-05-19","2025-05-19","2023-05-04","2023-10-02","2025-08-12","2025-03-27","2025-08-12","2024-07-22","2025-05-19","2023-10-11","2023-05-25","2023-03-06","2024-09-12","2024-09-12","2023-06-05","2024-07-26","2025-03-22","2022-08-19"],"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":[["","","OMEPRAZOLE","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","EPLERENONE","","","Select","Select",""],["","","TERAZOSIN HCL","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":""}]}]}