{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Roland G Miller","gend":0,"currentgend":"","add":"13 CAESAR POND LANE","city":"Bowdoin","state":"ME","zip":"04287","dob":"1949-04-20","age":"","mstatus":"","insh":"10000043354","cliId":"","pno":2078414274,"cno":"","email":"","ename":"","eno":"","pphy":"SKELTON, SARAH K","ppno":2077847388,"pcpadd":"Family Health Care Associates,190 Stetson Rd","pcpcity":"Auburn","pcpstate":"ME","pcpzip":"04210","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"13 CAESAR POND LANE","madd2":"","madd3":"","mcity":"Bowdoin","mstate":"ME","mzip":"04287","pcpfaxno":2077952043,"pcpnpi":1861489882,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9HM3Y23VN78","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C61","Z510","Z0000","R739","E785","J111","Z8616","Z87891","R339","Z96642","J449","Z08","Z8042","M1612","R9720","H401131","M7020","M47816","Z5111","J4489","J101","R5381","R112","N281","R338","R21","R0602","N401","M6289","N3040","Z0001","N529","M6281","Z79818","R530","R351","R6889","Z471","Z0189","A000","M25552","Z8546","Z923","N400","N3289","K219","R519","Z01818","R39198"],"date":["2025-09-23","2025-08-01","2025-05-06","2025-05-23","2025-05-06","2024-02-09","2024-02-09","2024-02-09","2025-09-23","2023-02-16","2024-09-08","2025-11-11","2025-03-28","2022-12-27","2025-01-07","2025-01-30","2025-02-24","2023-03-30","2025-04-02","2025-09-22","2024-02-09","2024-02-09","2024-02-09","2023-03-30","2025-08-01","2023-06-12","2024-02-09","2025-09-22","2025-09-23","2025-09-22","2024-04-29","2025-01-07","2025-09-23","2025-05-08","2025-07-01","2025-07-01","2023-12-26","2022-12-31","2023-05-04","2022-12-31","2022-12-06","2025-11-11","2025-11-11","2024-03-20","2024-03-20","2022-12-27","2022-12-27","2022-10-04","2022-08-30"],"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":[["","","TRAMADOL HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ALFUZOSIN HCL ER","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","ADVAIR HFA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","DULERA","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","PAXLOVID (EUA)","","","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":""}]}]}