{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barry L Campbell","gend":0,"currentgend":"","add":"304 CAMPBELL RD","city":"Littleton","state":"ME","zip":"04730","dob":"1949-09-12","age":"","mstatus":"","insh":"10000040466","cliId":"","pno":2075389583,"cno":"","email":"bcamp2009@yahoo.com","ename":"","eno":"","pphy":"THOMAS, CHRISTINE L","ppno":2075322234,"pcpadd":"PO BOX 40,","pcpcity":"CARIBOU","pcpstate":"ME","pcpzip":"47360040","pcpcounty":"","pcpid":"","pcpname":"SIGRID E TOMPKINS HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2075320127,"add2":"","add3":"","madd1":"304 CAMPBELL RD","madd2":"","madd3":"","mcity":"Littleton","mstate":"ME","mzip":"04730","pcpfaxno":2074983947,"pcpnpi":1235107848,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7CD9YF2TK48","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1151","E11621","I6381","M9903","M51360","M5416","M9905","M20002","R21","R338","Z98890","I70235","Z95820","Z7982","M5136","L089","Z0000","I739","R319","I70222","M25552","Z79899","D0339","Z4789","N201","R4781","M21611","R9720","L988","R220","Z4781","E119","D3131","L03115","R6889","Z01818","E1169","N401","Z4802","Z89411","L309","L03116","M2011","Z7984","N210","S2241XA","Z87448","T839XXD","E612","T148XXA","I70203","I700","Z95828","H2513","D225","L814","L821","L2089","L570","M5442","R339","Z466","I70239","E1140","N390","M869","M51369","M86471","T83031A","R509","R0989","M21612","I639","L858","R109","K580","D485","Z452","E11628","Z5189","M868X7","B9561","B954","M7989","Z48812","E785","E781","E039","I10","L97519","E1142","D649","Z01810","I70221","I119","S91301D","E113292","R0789","R079","M79605","M79604","L97518","I743","E1136","S91301A","Z4800"],"date":["2024-10-23","2025-03-11","2023-05-31","2025-09-02","2025-09-02","2025-09-02","2025-09-02","2024-06-10","2023-11-20","2024-04-15","2022-12-20","2025-06-17","2023-07-06","2025-06-27","2024-09-06","2024-04-18","2025-09-03","2025-06-03","2024-04-01","2025-06-27","2025-06-27","2025-06-27","2024-10-10","2025-05-12","2023-06-19","2023-05-23","2023-08-22","2025-02-21","2025-05-14","2024-05-01","2025-06-09","2025-09-03","2024-10-21","2024-05-22","2023-12-06","2024-09-20","2025-05-12","2024-07-18","2025-03-26","2025-06-09","2024-08-15","2024-10-08","2023-07-11","2023-07-11","2024-03-26","2024-03-03","2024-04-08","2024-04-05","2023-06-12","2022-12-29","2022-12-20","2022-12-20","2025-06-03","2025-08-11","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2025-08-19","2024-12-26","2024-04-01","2024-04-09","2023-07-06","2023-05-26","2024-04-08","2025-03-06","2024-12-26","2025-03-11","2024-04-02","2023-06-01","2025-03-28","2023-05-26","2023-06-06","2023-05-31","2023-08-30","2023-08-30","2024-07-19","2022-08-29","2022-08-26","2022-08-31","2022-08-31","2022-08-31","2022-08-31","2022-07-01","2022-06-03","2022-05-12","2022-05-12","2022-05-10","2022-05-10","2022-05-10","2022-05-10","2022-05-04","2022-03-28","2022-03-28","2022-03-28","2022-03-15","2021-11-08","2021-11-03","2022-01-27","2022-01-04","2022-01-04","2022-01-14","2022-01-21","2022-01-21","2022-02-04","2022-02-15"],"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",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","PHENYTOIN SODIUM EXTENDED","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","JANUMET","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","DILANTIN","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}