{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lonnie J Garland","gend":0,"currentgend":"","add":"195 MAIN RD","city":"PASSADUMKEAG","state":"ME","zip":"04475","dob":"1963-01-29","age":"","mstatus":"","insh":"10000045922","cliId":"","pno":2076316893,"cno":"","email":"bev36garland@hotmail.com","ename":"","eno":"","pphy":"KOFFMAN, DAVID J","ppno":2079073300,"pcpadd":"C\/O ST MARYS HEALTH SYSTEM - PROVIDER ENROLLMENT,PO BOX 7291","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42437291","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"334 MAIN RD N","madd2":"","madd3":"","mcity":"HAMPDEN","mstate":"ME","mzip":"04444","pcpfaxno":2079071923,"pcpnpi":1164402624,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5Y81NH7QJ04","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["L089","K651","K7460","I10","R791","E119","B181","C414","N340","K766","E279","E291","L02211","E1165","E871","M79606","Z743","R161","K820","N528","Z1211","F17210","E663","R7989","E278","R825","Z8659","K7030","Z23"],"date":["2024-02-27","2024-02-27","2024-11-12","2024-05-30","2023-01-31","2023-02-07","2024-11-12","2024-02-25","2024-02-25","2024-06-22","2024-10-02","2024-05-24","2024-04-15","2024-10-02","2024-02-24","2024-02-24","2024-02-24","2024-11-12","2024-11-12","2022-12-23","2023-02-18","2024-02-26","2024-04-05","2022-11-28","2024-06-22","2023-02-07","2023-02-07","2021-11-12","2021-12-31"],"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":[["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","FREESTYLE LITE TEST STRIP","","","Select","Select",""],["","","FREESTYLE LANCETS","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","FREESTYLE LITE METER","","","Select","Select",""],["","","FREESTYLE FREEDOM LITE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","INSULIN SYRINGE","","","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":""}]}]}