{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Andrew D Archer","gend":0,"currentgend":"","add":"60 ROCKY DUNN","city":"West Baldwin","state":"ME","zip":"04091","dob":"1950-10-26","age":"","mstatus":"","insh":"10000043588","cliId":"","pno":2076259380,"cno":"","email":"","ename":"","eno":"","pphy":"STEMM, ANDREA","ppno":2076258126,"pcpadd":"Sacopee Valley Health Center,70 Main St","pcpcity":"Porter","pcpstate":"ME","pcpzip":"04068","pcpcounty":"","pcpid":"","pcpname":"SACOPEE VALLEY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"60 ROCKY DUNN","madd2":"","madd3":"","mcity":"West Baldwin","mstate":"ME","mzip":"04091","pcpfaxno":2076257820,"pcpnpi":1952021917,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9XF7E37UQ55","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z510","C3412","J40","J9801","J449","Z08","Z85118","Z923","I2510","Z23","I2699","M67831","M5450","R300","N200","C61","N400","K5730","G5601","R052","Z8551","R8289","R0602","R9720","R051","Z6841","Z111","J9811","R0600","E785","I10","Z7901","M25562","R911","R0609","C3492","N132","N2889","D6851","R918","R7303","E7800","C672","Z6838","Z131","Z0000","D494","Z1211","K648","Z0101","I700","C3490","N401","R011","I6523","J029","R252","I3481","R931","C679","Z86711","R109","N201","M7621","Z6839","R9439","R531","I2782","Z48813","I779","R059","Z0389","Z6837","R3915","Z8546","R200","U071","I080","Z5112"],"date":["2023-08-15","2025-08-28","2025-02-20","2025-02-20","2025-08-28","2024-11-07","2025-07-31","2025-07-31","2025-05-14","2024-02-05","2024-01-30","2024-01-17","2024-11-08","2025-08-15","2025-03-24","2025-10-25","2025-05-09","2024-07-01","2024-01-17","2025-01-23","2025-08-03","2023-06-19","2024-03-19","2025-05-30","2025-02-18","2023-04-03","2023-03-07","2025-08-17","2023-08-21","2024-07-29","2025-04-02","2024-07-29","2024-10-13","2024-10-18","2024-08-26","2024-07-09","2025-04-09","2025-04-09","2023-10-06","2025-02-07","2025-04-02","2025-04-02","2025-08-15","2024-11-04","2024-08-05","2024-04-02","2023-03-24","2023-11-13","2023-11-13","2025-07-07","2024-01-29","2023-08-11","2025-08-15","2023-08-25","2025-04-21","2024-12-16","2025-09-04","2023-06-30","2023-11-06","2025-08-15","2023-10-27","2025-03-21","2025-04-25","2025-03-24","2023-06-27","2023-09-01","2023-10-27","2023-07-26","2023-07-19","2025-04-21","2025-02-20","2025-04-25","2024-12-12","2023-06-19","2025-08-03","2023-06-27","2023-02-17","2024-05-16","2022-08-16"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ERLEADA","","","Select","Select",""],["","","ORGOVYX","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PROAIR RESPICLICK","","","Select","Select",""],["","","ALBUTEROL SULFATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","DOXAZOSIN MESYLATE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","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":""}]}]}