{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lee F Griswold","gend":0,"currentgend":"","add":"2 CHERRYWOOD LN","city":"FALMOUTH","state":"ME","zip":"04105","dob":"1952-05-20","age":"","mstatus":"","insh":"10000054800","cliId":"","pno":2076507749,"cno":"","email":"lfgriswold@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":"2 CHERRYWOOD LN","madd2":"","madd3":"","mcity":"FALMOUTH","mstate":"ME","mzip":"04105","pcpfaxno":2078741483,"pcpnpi":1649239765,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7PH5AJ2VC76","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R079","D225","Z85828","L219","K635","I7121","N200","L570","R002","I080","I77810","I5030","K625","S80861A","W57XXXA","I351","R21","D485","L820","G453","J4540","Z0101","L821","Z872","I4720","I4729","D122","D124","D125","J339","R5383","I2510","I10","I358","L309","G4733","Z23","L578","I480","I495","R0683","I493","R001","Z87891","J069","J45901","G459","D3132","Z0000","I4891","R6889","H539","H538","R030","I4710","L2089","Z0001","R251","I6523","K219","R051","Z03818","J40","R059","J4541","H25813","N202","K5730","N201","Z98890","K4020","Z20822","R4182","Z79899","Z7982","Z01812","N486","R531","R9431","N132","R109","R110","Z125","D492","D099","C44519"],"date":["2025-09-17","2024-05-21","2025-08-28","2023-05-08","2025-06-12","2025-06-17","2024-08-21","2025-07-01","2023-10-05","2025-06-17","2025-06-17","2025-06-17","2025-01-23","2024-07-31","2024-07-31","2024-11-14","2025-08-28","2025-11-06","2025-08-28","2025-01-07","2025-06-16","2025-06-23","2025-05-14","2025-05-14","2023-10-27","2025-11-17","2025-06-12","2025-06-12","2025-06-12","2024-09-19","2024-08-21","2024-05-07","2025-06-17","2024-11-14","2025-08-28","2025-10-30","2025-09-08","2023-05-08","2025-11-17","2025-11-17","2025-11-09","2025-11-09","2025-09-17","2025-09-17","2023-03-06","2023-03-06","2024-11-06","2022-12-20","2023-12-01","2025-09-17","2023-01-01","2024-11-07","2024-10-20","2023-12-13","2025-01-07","2025-08-20","2024-12-02","2022-11-29","2024-11-07","2023-11-17","2022-09-05","2022-09-05","2022-09-05","2022-06-29","2022-06-29","2022-06-09","2022-05-17","2022-05-17","2022-05-17","2022-05-26","2022-04-29","2022-04-27","2022-04-29","2022-04-29","2022-04-29","2022-04-27","2022-04-22","2022-04-17","2022-04-17","2022-04-17","2022-04-16","2022-04-16","2021-11-23","2021-12-21","2021-12-21","2022-01-05"],"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":[["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","NORTRIPTYLINE HCL","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","BETAMETHASONE VALERATE","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","TACROLIMUS","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUTICASONE-VILANTEROL","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","DUPIXENT PEN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","PEG-3350 AND ELECTROLYTES","","","Select","Select",""],["","","BISOPROLOL FUMARATE","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","HAVRIX","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","SYMBICORT","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","XIAFLEX","","","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":""}]}]}