{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Arthur D Robinson","gend":0,"currentgend":"","add":"314 HALLOWELL RD","city":"Chelsea","state":"ME","zip":"04330","dob":"1950-08-22","age":"","mstatus":"","insh":"10000050484","cliId":"","pno":2076229860,"cno":"","email":"artmaryrobinson@gmail.com","ename":"","eno":"","pphy":"GUZZETTI, PETER D","ppno":2076238434,"pcpadd":"Kennebec Internal Medicine,9 Glenridge Dr","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"KENNEBEC INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"314 HALLOWELL RD","madd2":"","madd3":"","mcity":"Chelsea","mstate":"ME","mzip":"04330","pcpfaxno":2076214370,"pcpnpi":1306885207,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9YW0RG8UP07","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J45909","Z8709","J4489","Z7951","Z77090","R1032","R739","E785","I10","R5383","Z125","J449","R062","D485","Z0100","L814","D225","L821","Z08","E559","M109","E539","Z0000","E291","H903","R946","J3489","J320","Z1211","D122","Z7722","D352","J329","I861","Z9079","K5730","R1909","K648","N62","J40","J339","R6889","E298","R634","R9720","K5790","R7989","T1512XA","S0502XA","Z23","Z98890"],"date":["2023-07-24","2023-07-24","2024-03-15","2025-03-18","2024-03-15","2024-08-01","2025-06-12","2025-06-12","2025-06-12","2025-06-12","2023-06-05","2025-03-18","2023-09-14","2024-12-12","2025-04-02","2024-12-12","2024-12-12","2024-12-12","2024-12-12","2025-06-12","2025-06-12","2025-06-12","2025-06-23","2025-10-23","2024-06-26","2025-06-23","2023-09-12","2023-09-12","2025-06-24","2025-06-24","2025-03-18","2023-09-02","2023-09-02","2024-10-01","2025-10-15","2025-06-24","2024-08-01","2025-06-24","2023-08-07","2023-07-13","2025-05-12","2023-03-29","2023-06-15","2025-10-23","2025-06-23","2023-06-15","2023-06-15","2025-01-22","2022-11-21","2022-10-26","2022-08-09"],"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":[["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","BUDESONIDE","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","TOBRADEX","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}