{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Arnona K Silsby","gend":1,"currentgend":"","add":"144 MOOSE HILL RD","city":"Osborn","state":"ME","zip":"04605","dob":"1941-03-25","age":"","mstatus":"","insh":"10000037644","cliId":"","pno":2075845642,"cno":"","email":"declined@073025.com","ename":"","eno":"","pphy":"PATTEN, JOHN L","ppno":2078620300,"pcpadd":"St Joseph Family Medicine Hampden,21 Western Ave","pcpcity":"Hampden","pcpstate":"ME","pcpzip":"04444","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE HAMPDEN","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"144 MOOSE HILL RD","madd2":"","madd3":"","mcity":"Osborn","mstate":"ME","mzip":"04605","pcpfaxno":2077778800,"pcpnpi":1669577938,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6RC4WR5JM79","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1122","Z9689","Z45018","D135","Z09","Z0000","N200","N6002","Z466","I442","H401132","N1832","I4891","D6869","L03032","D132","H2512","I517","I5020","H2511","E1142","I130","I4821","H43393","Z7901","I10","M19012","M109","M79675","S81802A","N281","Z98890","R0989","Z950","I340","I4819","Z1231","I2510","I495","K922","R0789","Z4589","I083","Z01810","R928","Z87891","I4811","I2720","I3481","K317","H2513","R6889","I5042","I77810","Z01818","I080","R921","R0602","I5040","I420","I447","T85898A","K838","Y838","N1831","H43813","I21A1","I5043","R079","I110","R110","K7689","K824"],"date":["2025-07-25","2025-09-08","2025-07-06","2025-06-26","2024-12-03","2025-01-23","2025-04-09","2023-10-06","2025-04-24","2022-11-09","2025-03-11","2025-01-23","2025-04-09","2023-05-23","2023-03-13","2025-06-17","2023-02-02","2024-05-16","2023-04-06","2023-02-23","2024-03-30","2024-03-30","2023-04-06","2025-03-11","2025-04-09","2025-04-09","2024-03-30","2023-03-22","2023-03-16","2022-10-25","2025-06-05","2025-04-24","2022-11-07","2022-11-08","2024-11-19","2024-11-19","2024-11-07","2023-04-06","2023-04-06","2024-11-25","2024-11-25","2025-07-10","2025-05-21","2025-02-01","2023-10-06","2025-09-08","2023-03-16","2025-05-21","2024-05-16","2025-05-20","2022-11-28","2023-03-30","2022-11-09","2023-02-08","2025-04-01","2024-09-10","2023-10-06","2024-10-15","2022-10-31","2022-10-31","2022-10-31","2025-09-08","2025-09-08","2025-09-08","2022-12-01","2022-11-28","2022-09-09","2022-09-09","2022-09-15","2022-09-23","2022-09-07","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":[["","","METFORMIN HCL ER","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","KLOR-CON M20","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","BUMETANIDE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","TIMOLOL MALEATE","","","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":""}]}]}