{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"J Thomas Albright","gend":0,"currentgend":"","add":"24 MOULTON LANE","city":"YORK","state":"ME","zip":"03909","dob":"1946-08-27","age":"","mstatus":"","insh":"10000046039","cliId":"","pno":2073371992,"cno":"","email":"jta.ortho@gmail.com","ename":"","eno":"","pphy":"RUSK, SCOTT F","ppno":2076468386,"pcpadd":"\tYork Hospital Internal Medicine of York,\t277 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":2073371464,"add2":"","add3":"","madd1":"24 MOULTON LANE","madd2":"","madd3":"","mcity":"YORK","mstate":"ME","mzip":"03909","pcpfaxno":2076412855,"pcpnpi":1891800546,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6DE4WU2VV90","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R748","I2510","S62636A","L570","D649","R6889","Z8249","E785","I6523","R059","R001","L720","C44612","D044","C44719","D485","L821","L814","D225","L578","Z0000","Z0101","S62636B","D3132","D0439","L309","R2231","R9439","E7800","R010","S62639D","M79644","H00022","Z7189","T8484XA","S62636D","Z967"],"date":["2023-05-30","2025-10-30","2023-12-08","2025-05-08","2024-11-20","2023-10-13","2025-02-20","2025-10-24","2025-05-23","2025-07-29","2025-06-10","2023-04-07","2025-07-24","2025-07-24","2025-06-26","2025-05-08","2025-05-08","2025-05-08","2025-05-08","2025-05-08","2024-11-14","2025-05-05","2023-12-08","2025-05-05","2023-05-31","2024-04-30","2023-12-07","2025-04-29","2025-02-13","2025-03-18","2023-12-11","2024-01-10","2024-08-06","2023-04-25","2024-02-08","2024-02-08","2023-12-21"],"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":[["","","EZETIMIBE","","","Select","Select",""],["","","NEBIVOLOL HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","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":""}]}]}