{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Martin D Taylor","gend":0,"currentgend":"","add":"10 NOTTINGHAM LANE","city":"BELGRADE","state":"ME","zip":"04917","dob":"1950-10-10","age":"","mstatus":"","insh":"10000052342","cliId":"","pno":2074653299,"cno":"","email":"","ename":"","eno":"","pphy":"STEVENS, ROBERT B","ppno":2074652181,"pcpadd":"Oakland Family Medicine,9 Pleasant St","pcpcity":"Oakland","pcpstate":"ME","pcpzip":"04963","pcpcounty":"","pcpid":"","pcpname":"OAKLAND FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 483","madd2":"","madd3":"","mcity":"Oakland","mstate":"ME","mzip":"04963","pcpfaxno":2074654629,"pcpnpi":1407176175,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9DD1YA8NU96","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N1830","Z471","Z96641","Z87891","K2270","K2950","D128","K6389","I7143","M25559","M1A9XX1","D1779","M167","I129","L989","L570","M25551","M1611","Z0000","R251","Z8616","W109XXA","Z1211","K621","K5730","D124","D123","Z1210","H40003","M1990","N189","R6889","Z7952","Z122","I2510","I5189","I10","H40053","R609","Z98890","Z905","K2289","Z0101","Z1283","I080","K3189","R001","J329","B9689","R058","H5213","H52223","H26492","Z961","H43813","Z0001","R600","Z9884","Z6829","R1031","M25561","M19042","Z87442","D220","R197","M160","M064"],"date":["2025-11-12","2025-06-14","2025-06-14","2025-03-11","2025-06-15","2025-06-06","2023-08-29","2023-08-29","2025-06-14","2025-06-14","2025-09-05","2025-07-14","2023-06-21","2025-03-11","2025-03-18","2025-06-24","2025-06-27","2023-06-21","2022-12-12","2022-12-12","2022-12-12","2025-06-14","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2023-08-29","2025-06-06","2023-08-18","2023-02-20","2023-02-20","2023-08-18","2024-01-26","2025-03-04","2023-10-06","2023-10-17","2023-10-06","2025-06-09","2025-06-27","2023-06-21","2025-03-11","2025-07-14","2024-12-09","2024-03-12","2025-03-13","2025-07-14","2024-12-13","2025-01-03","2025-01-03","2025-01-03","2023-05-17","2023-05-17","2023-05-17","2023-05-17","2023-05-17","2023-12-26","2022-11-04","2022-09-27","2022-09-27","2022-08-23","2022-08-23","2022-08-23","2022-05-26","2022-01-04","2021-11-09","2022-02-15","2022-02-15"],"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 MONOHYDRATE","","","Select","Select",""],["","","OTEZLA","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","PEG 3350-ELECTROLYTE","","","Select","Select",""],["","","FLOVENT HFA","","","Select","Select",""],["","","ERYTHROMYCIN","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}