{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James R Pizzo","gend":0,"currentgend":"","add":"19 EDGEWORTH AVE","city":"PORTLAND","state":"ME","zip":"04103","dob":"1946-10-20","age":"","mstatus":"","insh":"10000052507","cliId":"","pno":2077721391,"cno":"","email":"jimpizzo531@gmail.com","ename":"","eno":"","pphy":"KLAYMAN, ANDREA S","ppno":2077745816,"pcpadd":"InterMed,84 Marginal Way Ste 800","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"19 EDGEWORTH AVE","madd2":"","madd3":"","mcity":"PORTLAND","mstate":"ME","mzip":"04103","pcpfaxno":2078741483,"pcpnpi":1780856963,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5TD2KE1XQ23","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C61","R600","M2041","M7741","M2011","M1712","Z01818","M2242","G8918","E785","M0609","Z79899","D0439","M79671","Z981","M25562","Z96652","Z471","Z96653","Z510","H43813","Z01810","R030","R29890","Z92241","M8588","Z23","N429","N323","G43B0","H1789","R6889","K635","Z1211","K5730","D225","L821","Z872","L578","Z09","Z0000","H6123","E559","M8580","L570","L814","H02402","N4289","N390","D485","D1801","Z0001","M25561","I700","Z01812","N401","R109","R7309","R9720","M0579"],"date":["2025-06-05","2023-09-11","2023-09-11","2023-09-11","2023-09-11","2024-03-20","2024-03-06","2024-03-20","2024-03-20","2024-03-20","2025-09-24","2025-09-24","2024-10-22","2023-01-30","2023-01-30","2024-06-06","2025-03-19","2025-03-19","2024-09-18","2024-09-16","2024-08-13","2024-03-11","2024-03-11","2023-04-25","2023-04-25","2023-04-25","2025-10-23","2023-09-23","2023-09-23","2024-05-08","2024-08-13","2023-01-31","2024-07-09","2024-07-09","2024-07-09","2025-10-24","2025-10-24","2025-10-24","2025-10-24","2025-03-19","2025-01-27","2025-01-27","2023-05-17","2025-11-05","2023-10-12","2023-10-12","2024-08-13","2023-10-20","2025-07-15","2024-10-22","2024-10-22","2024-01-22","2023-03-21","2024-01-22","2022-09-09","2022-06-30","2022-01-21","2022-01-21","2022-01-21","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":[["","","METHOTREXATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","CALCIPOTRIENE","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","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":""}]}]}