{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Sidney S Thaxter","gend":0,"currentgend":"","add":"16 MARIGOLD LN","city":"Falmouth","state":"ME","zip":"04105","dob":"1944-11-10","age":"","mstatus":"","insh":"10000050283","cliId":"","pno":2076536692,"cno":"","email":"saintfelix2nd@gmail.com","ename":"","eno":"","pphy":"EMERY, PETER","ppno":2077745816,"pcpadd":"100 FODEN RD WEST,STE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 MARIGOLD LN","madd2":"","madd3":"","mcity":"Falmouth","mstate":"ME","mzip":"04105","pcpfaxno":2078741483,"pcpnpi":1649239765,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9UE5E29NF66","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I2510","I350","Z0000","R079","I442","R051","Z006","I10","H6123","E785","I700","Z125","L570","H6120","B079","I088","I082","Z85828","L821","L578","B353","R6889","H938X3","I083","Z01818","I422","C44320","I77810","R61","I708","Z950","Z953","C44309","Z951","Z955","Z23","L820","D230","M19012","Z952","I361","I517","R4182","R351","N529","Z0100","D492","C44329","R9439","I209","Z48813","R918","I3481","S30860A","W57XXXA","L0390","J9811","I519","M7532","Z0001","I25119","D123","Z86010","K5730","B078","B354","Z20822"],"date":["2025-06-02","2024-06-12","2025-02-07","2024-11-13","2025-06-16","2024-02-16","2024-02-09","2025-06-16","2023-08-03","2025-07-24","2023-12-04","2024-01-10","2025-08-01","2024-01-31","2025-08-01","2023-10-06","2024-02-07","2025-08-01","2023-10-20","2023-10-20","2025-08-01","2023-01-04","2025-01-29","2025-03-31","2024-02-01","2025-03-31","2024-06-24","2025-03-31","2024-11-13","2023-11-28","2025-09-16","2025-03-31","2024-04-09","2025-03-10","2023-10-26","2025-10-09","2023-01-24","2024-10-08","2024-02-26","2025-06-16","2024-02-08","2024-03-08","2024-02-07","2024-03-19","2024-03-19","2024-12-12","2024-10-08","2024-05-16","2024-11-13","2024-11-13","2024-02-07","2024-02-07","2024-03-08","2025-08-08","2025-08-08","2025-08-08","2024-02-01","2024-03-08","2024-02-26","2022-01-07","2022-01-07","2022-01-06","2022-01-06","2022-01-06","2022-01-19","2022-01-19","2022-02-17"],"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":[["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","FAMCICLOVIR","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","PFIZER COVID (12Y UP) VAC(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":""}]}]}