{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John R Mccann","gend":0,"currentgend":"","add":"117 HACKER ROAD","city":"BRUNSWICK","state":"ME","zip":"04011","dob":"1949-01-16","age":"","mstatus":"","insh":"10000044794","cliId":"","pno":2072333395,"cno":"","email":"","ename":"","eno":"","pphy":"FRASER, ROBERT J","ppno":2077745816,"pcpadd":"100 FODEN RD. W,SUITE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41066143","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 4765","madd2":"","madd3":"","mcity":"Portland","mstate":"ME","mzip":"04112","pcpfaxno":2078741483,"pcpnpi":1134206352,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3M48F00GG10","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R112","D0439","Z8546","E785","I10","D649","K56600","Z23","R110","R6883","D692","L578","Z85828","L570","H903","H9313","L0390","Z0001","M1811","M19041","K56609","Z0000","Z125","H52203","H11042","H2513","I77810","I358","K627","Z538","K648","D485","R944","Z08","Z923","C61","I350","R351","R21","R202","E870","E538","Z510","Q231","H02883","H02886","R6889","Z0279"],"date":["2025-10-23","2024-12-16","2025-05-29","2025-05-29","2025-05-29","2025-05-29","2023-08-28","2025-09-17","2023-08-28","2023-08-28","2023-09-20","2023-09-20","2023-09-20","2025-11-07","2023-09-18","2023-09-18","2023-01-06","2025-06-05","2023-06-29","2023-06-29","2023-08-28","2024-05-23","2024-05-23","2025-10-09","2023-02-10","2025-10-09","2025-06-12","2025-04-15","2023-12-01","2023-12-01","2023-12-01","2024-11-07","2025-06-19","2022-12-09","2022-12-09","2023-05-25","2025-06-12","2022-11-16","2022-08-31","2022-08-31","2022-05-17","2022-05-20","2022-02-02","2021-11-05","2021-12-15","2021-12-15","2021-12-15","2021-10-21"],"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":[["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE ER","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","BOOSTRIX TDAP","","","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":""}]}]}