{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David W Erde","gend":0,"currentgend":"","add":"11 ALLING DR","city":"Gray","state":"ME","zip":"04039","dob":"1947-05-02","age":"","mstatus":"","insh":"10000039512","cliId":"","pno":2077122576,"cno":"","email":"daserde@securespeed.us","ename":"","eno":"","pphy":"CROTHERS, DANIEL S","ppno":2078282402,"pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"11 ALLING DR","madd2":"","madd3":"","mcity":"Gray","mstate":"ME","mzip":"04039","pcpfaxno":2078282433,"pcpnpi":1336601996,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5VE6R98AU77","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25642","M25532","M79642","M19032","R1032","M6281","M1711","M25632","H16141","S92514A","M25561","G8929","H2511","H2512","M25511","Z0101","S1096XA","I2510","I10","E7800","M19031","S0501XA","S20361A","B354","E785","K219","M7541","R6889","Z4889","S299XXA","J029","H2513","H40033","H43813","K449","K222","L570","S301XXA","S20212A","W01190A","S6990XD","E538","L309","M19012","M25512","M7989","Z125","E559","R042","S43402A","N323","I7090","N281","S0990XA","W010XXA","M7918","G4719","R0683","G3184","M9902","M5414","M9901","M9905","H903","M19042","M19041","N400","R0789","R059","B070","L84","M25559","Z23","R1020","M25649","M25712","M542","M47812","M4692"],"date":["2024-04-01","2024-08-27","2025-07-22","2024-01-09","2023-10-09","2024-04-01","2024-10-15","2024-08-27","2024-10-09","2024-04-23","2024-10-07","2024-10-15","2024-08-06","2024-07-16","2023-09-20","2025-03-25","2024-04-23","2024-02-08","2024-07-16","2024-02-08","2023-09-25","2023-12-16","2024-08-12","2023-12-30","2025-11-11","2024-07-16","2023-09-20","2023-04-05","2024-02-22","2023-10-09","2024-01-19","2024-05-08","2024-05-08","2024-05-08","2023-10-24","2023-10-24","2024-11-21","2023-10-09","2023-10-09","2023-10-09","2023-11-01","2025-11-11","2024-02-13","2024-12-12","2024-12-12","2024-12-12","2024-11-04","2024-11-04","2024-10-29","2024-12-12","2023-10-09","2023-10-09","2023-10-09","2024-12-12","2024-12-12","2025-11-17","2025-09-04","2025-09-04","2025-08-27","2022-12-14","2022-12-14","2022-12-14","2022-12-14","2025-07-25","2023-06-02","2023-06-02","2025-11-11","2023-02-14","2023-02-14","2023-05-18","2023-05-18","2025-10-27","2025-11-18","2025-10-27","2025-07-22","2022-08-12","2022-08-12","2022-08-12","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":[["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","ALPRAZOLAM","","","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":""}]}]}