{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael P Bryan","gend":0,"currentgend":"","add":"12 MONROE AVE","city":"WESTBROOK","state":"ME","zip":"04092","dob":"1952-09-20","age":"","mstatus":"","insh":"10000056400","cliId":"","pno":2076508317,"cno":"","email":"bryan.michael52@yahoo.com","ename":"","eno":"","pphy":"RICHARDS, SAMANTHA","ppno":2077984050,"pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"12 MONROE AVE","madd2":"","madd3":"","mcity":"WESTBROOK","mstate":"ME","mzip":"04092","pcpfaxno":2077984018,"pcpnpi":1689960114,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6NX7MG2TG42","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C44519","M75101","M12811","I77810","L281","F332","T18128A","K2090","K449","M4802","M5412","I349","Z87891","Z125","M25511","Z01818","Z0101","H52223","H7292","L814","L821","L578","Z85828","H903","H6983","I739","H5203","F341","S4991XA","H2513","H04123","M25512","C44319","K621","Z1211","K5730","K648","S46011A","R918","M19012","M50322","M47812","M4312","Z5321","B351","D229","M542","K2100","K222","M7542","H6692","J069","H5201","S46109A","C4441","L570","K219","F32A","M1811","M7989","Z981","R5383","H2511","H2512","Z98890","F900","M75102","L738","C44612","H26491","D224","H26493","S6010XA","M25712","I059","Z952","I071","Z95818","D128","M79603","M7541","M12812","F909","Z96651","Z0000","M75122","R1310","Z13228","Z1159"],"date":["2025-01-20","2023-09-21","2023-09-21","2025-04-10","2023-09-08","2025-09-22","2025-10-03","2025-10-03","2025-10-03","2025-10-14","2025-10-14","2025-10-14","2025-10-14","2025-01-23","2023-03-21","2024-11-11","2025-06-26","2025-06-26","2024-11-15","2025-01-20","2025-08-05","2025-01-20","2025-08-05","2025-02-18","2024-11-15","2024-11-15","2023-04-10","2023-10-19","2023-02-21","2023-04-10","2024-10-28","2025-07-07","2023-08-22","2023-08-17","2023-08-17","2023-08-17","2023-08-17","2023-03-21","2024-07-10","2025-08-21","2025-07-07","2025-10-16","2025-08-26","2024-07-10","2025-08-05","2025-08-05","2025-08-26","2023-08-17","2023-08-17","2023-12-28","2024-07-11","2024-07-11","2024-05-29","2023-02-21","2024-11-21","2024-06-14","2025-10-03","2025-10-03","2023-11-21","2025-10-16","2025-10-16","2023-04-25","2023-06-06","2023-06-27","2023-04-25","2023-07-24","2025-09-04","2023-12-12","2023-06-12","2024-10-28","2023-06-12","2024-10-28","2023-12-12","2025-08-21","2025-04-10","2025-04-10","2025-04-10","2023-04-17","2023-08-17","2025-08-26","2023-12-28","2025-09-04","2023-06-14","2024-10-09","2024-10-10","2025-08-07","2025-10-16","2023-01-26","2023-01-26"],"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":[["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","LISDEXAMFETAMINE DIMESYLATE","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TERBINAFINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","VYVANSE","","","Select","Select",""],["","","MYRBETRIQ","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","OFLOXACIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","CEPHALEXIN","","","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":""}]}]}