{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Arthur S Moore","gend":0,"currentgend":"","add":"322 MEADOW RD","city":"WOOLWICH","state":"ME","zip":"04579","dob":"1960-02-19","age":"","mstatus":"","insh":"10000047226","cliId":"","pno":2074420434,"cno":"","email":"lyn-nc@hotmail.com","ename":"","eno":"","pphy":"SOMMER, JOHN E","ppno":2077984400,"pcpadd":"Martins Point Health Care,114 Bath Rd","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"322 MEADOW RD","madd2":"","madd3":"","mcity":"WOOLWICH","mstate":"ME","mzip":"04579","pcpfaxno":2078287850,"pcpnpi":1275732364,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5A52JJ8UF18","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":["N50811","I2510","R079","K5732","T24201A","F1220","R42","Z1211","Z125","T24301A","M5450","Z79899","T24331A","K4090","Z23","M546","H8111","G894","D120","D123","D128","K5730","K838","N281","M47816","E785","I10","K219","I639","T24291D","Z8719","F418","Z0000","J45909","Z87891","M4186","Z86010","K635","K621","R109","N401","R682","R1011","M5414","N452","H8110"],"date":["2024-01-16","2025-03-14","2025-03-14","2024-10-28","2024-06-12","2024-05-29","2025-05-20","2023-08-23","2024-10-28","2024-05-29","2025-06-05","2023-03-09","2024-05-29","2024-01-16","2024-12-02","2025-03-10","2025-05-08","2025-05-08","2023-08-23","2023-08-23","2023-08-23","2025-03-14","2025-03-14","2025-03-14","2025-06-26","2024-10-28","2025-06-05","2024-12-02","2025-04-25","2024-06-26","2023-08-23","2023-08-23","2024-12-02","2024-12-02","2024-05-29","2025-02-28","2023-08-23","2023-08-23","2023-08-23","2025-03-14","2022-11-29","2022-11-29","2024-01-22","2025-03-18","2024-01-22","2025-06-05"],"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":[["","","ONDANSETRON ODT","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","DICYCLOMINE HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","SILVER SULFADIAZINE","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","CHLORTHALIDONE","","","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":""}]}]}