{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Douglas A Carnrick","gend":0,"currentgend":"","add":"3 PINEHURST ST","city":"Winslow","state":"ME","zip":"04901","dob":"1951-04-20","age":"","mstatus":"","insh":"10000048374","cliId":"","pno":2078728221,"cno":2073145624,"email":"carnrick@roadrunner.com","ename":"","eno":"","pphy":"WALDRON, ROSALIND","ppno":2078725139,"pcpadd":"32 College Ave Ste 203,","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"ROSALIND WALDRON MD","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"3 PINEHURST ST","madd2":"","madd3":"","mcity":"Winslow","mstate":"ME","mzip":"04901","pcpfaxno":2078725148,"pcpnpi":1346225711,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4E87YN8YN66","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["G4739","H26492","L821","L570","L820","D1801","G4733","I25118","H532","Z0101","H5050","H25811","H20013","G510","H44113","H3093","H35033","H903","K5000","I2510","Z0000","F17210","Z136","Z1339","Z1331","Z98890","K5140","R400","M1711","Z87891","Z955","G4730","L308","L578","H2000","H43811","H2511","Z961","K5090","I351","H30113","R079","I25110","R9439","R9431","Z1211","H02432","H52223","H524","E7849","D492","K8020","K5730","M25561","I083","E785","R194","D123","K648","K5010","L718","R69","H4921","H2013","K529","R0602","I10","H34823","L817","R1915","R197","K6389"],"date":["2025-11-03","2022-11-28","2025-01-21","2025-10-16","2025-01-21","2025-01-21","2025-10-30","2024-11-22","2023-08-22","2023-08-14","2025-02-04","2025-02-04","2025-02-04","2024-08-13","2025-04-14","2025-04-14","2025-04-14","2025-05-07","2025-06-04","2024-12-20","2024-08-28","2024-08-28","2024-08-28","2024-08-28","2024-08-28","2025-05-01","2023-02-27","2025-08-15","2025-08-19","2025-08-19","2025-04-08","2025-08-29","2023-10-05","2023-10-05","2025-10-22","2025-10-22","2025-10-22","2025-10-22","2023-08-17","2025-04-08","2023-09-28","2024-11-23","2024-11-15","2024-11-19","2024-11-15","2023-02-27","2023-03-02","2024-08-01","2024-08-01","2024-12-20","2024-06-25","2023-08-17","2023-08-17","2024-12-06","2025-11-12","2024-09-04","2023-06-20","2023-02-27","2023-02-27","2023-02-27","2023-01-12","2024-07-16","2023-10-25","2023-10-25","2024-02-08","2024-12-20","2024-12-20","2022-10-18","2022-08-15","2022-06-20","2022-06-20","2022-06-20"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","MESALAMINE","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","VASCEPA","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","ICOSAPENT ETHYL","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","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":""}]}]}