{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Paul D Williams","gend":0,"currentgend":"","add":"168 GRAMMAR ST","city":"Sanford","state":"ME","zip":"04073","dob":"1950-11-23","age":"","mstatus":"","insh":"10000043649","cliId":"","pno":2073241947,"cno":"","email":"","ename":"","eno":"","pphy":"ADAMS, TODD","ppno":2076468386,"pcpadd":"York Hospital Internal Medicine of York,277 Post Rd","pcpcity":"Moody","pcpstate":"ME","pcpzip":"04054","pcpcounty":"","pcpid":"","pcpname":"WEBHANNET INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2076517735,"add2":"","add3":"","madd1":"168 GRAMMAR ST","madd2":"","madd3":"","mcity":"Sanford","mstate":"ME","mzip":"04073","pcpfaxno":2076412855,"pcpnpi":1427165778,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7JW3UA8RP77","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1165","I441","M25552","E119","H903","H26492","M1711","I2510","M5416","G4733","M19031","M170","Z23","M47816","M160","M7062","M25511","M48062","R059","M5136","M48061","M4316","K5731","K6289","K51511","Z09","Z87442","N1330","N281","Z0000","M5432","R2689","R202","R531","R6889","M25561","M5135","M47817","H2511","Z961","N132","K6389","K439","E278","N201","K625","K5190","Z0101","H52223","H259","N200","H35342","Z125","J449","J45909","N400","H43822","M25461","L570","M5116","M4726","H2512","M5127","H524","L718","L814","L821","Z08","H52213","H2513","H43811","G894","Z01818","M5441","M5442","Z87891","M5450","K529","H33009","D225","D2261","D2262"],"date":["2024-08-09","2025-09-02","2024-09-12","2025-10-20","2022-12-15","2024-04-17","2025-09-05","2025-09-11","2024-09-10","2025-10-28","2022-12-27","2025-03-20","2023-09-28","2024-01-16","2024-01-16","2023-09-26","2023-09-26","2024-02-27","2023-08-18","2024-02-22","2024-04-12","2024-02-22","2023-01-20","2023-01-20","2023-01-20","2023-09-14","2024-01-17","2023-09-14","2024-01-15","2024-12-05","2023-12-11","2023-12-11","2023-12-11","2023-12-11","2023-12-30","2024-12-19","2023-12-30","2023-12-30","2025-01-28","2025-01-28","2023-08-17","2023-08-17","2023-08-17","2023-08-17","2023-09-14","2023-01-20","2023-09-07","2024-04-25","2024-04-25","2023-03-16","2024-01-15","2023-05-30","2022-11-28","2023-11-01","2023-11-01","2023-11-01","2023-04-18","2024-12-19","2024-04-02","2023-10-26","2023-10-26","2023-03-16","2024-02-22","2023-04-20","2023-03-20","2023-03-20","2023-03-20","2023-03-20","2022-12-20","2022-12-20","2022-12-20","2024-01-30","2025-11-11","2023-10-26","2023-10-11","2023-10-11","2023-12-30","2023-01-20","2022-10-26","2022-09-26","2022-09-26","2022-09-26"],"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":[["","","MESALAMINE","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","MORPHINE SULFATE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ACCU-CHEK AVIVA PLUS","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","DIFLUPREDNATE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}