{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Walter H Dunakin","gend":0,"currentgend":"","add":"197 E NEWPORT RD","city":"STETSON","state":"ME","zip":"04488","dob":"1950-02-05","age":"","mstatus":"","insh":"10000046462","cliId":"","pno":2079442312,"cno":"","email":"babsdun@aol.com","ename":"","eno":"","pphy":"MAMULA, MEGHAN R","ppno":2079891567,"pcpadd":"Brewer Medical Center,735 Wilson St","pcpcity":"Brewer","pcpstate":"ME","pcpzip":"04412","pcpcounty":"","pcpid":"","pcpname":"BREWER MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"197 E NEWPORT RD","madd2":"","madd3":"","mcity":"STETSON","mstate":"ME","mzip":"04488","pcpfaxno":2079470435,"pcpnpi":1457456733,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9AY2JV4KE81","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N281","M25562","Z4509","S83242A","S83282A","N529","R7309","I2510","E785","I081","M5459","G5603","S060X1A","Z23","Z45018","M1712","Z122","Z13820","M48061","M5116","M4726","M539","M899","Z79899","F17290","I495","M23322","M25462","M8588","Z125","E539","D7589","I739","R209","N2889","M11262","R55","Z87891","M25511","C801","L570","Z86010","D122","K640","I429","D123","I252","Z1211","K635","Z950","J9811","I6523","I7389","J449","G5601","G5602","Z955","G629","Z0000","Z0101","H5203","H524","H40033"],"date":["2025-06-05","2024-12-26","2025-08-31","2025-07-29","2025-07-29","2023-11-14","2024-11-19","2025-08-04","2025-06-03","2024-12-11","2025-05-20","2025-10-01","2023-01-03","2025-09-16","2025-10-23","2025-10-31","2024-12-19","2025-05-22","2025-04-12","2025-04-12","2025-04-12","2025-06-09","2025-08-14","2025-08-14","2025-08-14","2025-10-21","2024-11-22","2024-11-22","2025-06-09","2024-11-19","2024-11-19","2025-05-22","2025-04-25","2025-04-25","2025-05-30","2024-10-17","2024-05-07","2024-12-19","2023-05-09","2025-05-30","2025-02-11","2024-08-20","2024-08-20","2024-08-20","2025-08-04","2024-08-20","2025-08-04","2024-08-20","2024-08-20","2025-10-08","2025-10-08","2025-03-13","2025-03-13","2024-04-03","2025-10-06","2025-10-06","2025-02-27","2025-01-23","2025-06-24","2022-07-06","2022-07-06","2022-07-06","2022-07-06"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","CAPVAXIVE","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","CLOTRIMAZOLE-BETAMETHASONE","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","NITROGLYCERIN","","","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":""}]}]}