{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas P Walker","gend":0,"currentgend":"","add":"6 PARK WAY","city":"AUBURN","state":"ME","zip":"04210","dob":"1941-12-23","age":"","mstatus":"","insh":"10000059305","cliId":"","pno":2075001445,"cno":"","email":"profwacha@gmail.com","ename":"","eno":"","pphy":"HUNTRESS, LAURIE A","ppno":2075243501,"pcpadd":"180 CHURCH HILL RD,STE 1","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"6 PARK WAY","madd2":"","madd3":"","mcity":"AUBURN","mstate":"ME","mzip":"04210","pcpfaxno":2075242459,"pcpnpi":1629046693,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8MT3ED7FX91","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R300","Z952","R531","R0789","I350","I358","D500","K2270","Z8719","R918","J984","R609","M1990","R109","I2510","R931","I493","R030","D509","Z136","R079","R008","I4710","I498","I456","J449","Z01818","Z9049","I083","M25562","R194","D649","K922","D72829","E871","G8929","K5731","D62","M25561","K449","K3189","Z87891","Z20822","R55","M170","Z125","E785","J189","E860","N400","M25861","M25862","R238","Z0000"],"date":["2025-08-18","2025-11-10","2024-11-08","2024-11-08","2025-11-11","2025-02-19","2023-08-24","2023-08-24","2023-08-24","2025-09-11","2025-11-12","2023-05-22","2023-05-22","2023-08-22","2025-10-09","2025-10-09","2025-10-01","2025-10-15","2025-08-19","2024-08-09","2025-09-08","2024-11-09","2025-03-12","2025-03-12","2024-11-13","2025-09-11","2025-11-10","2023-08-22","2025-11-10","2023-05-22","2023-05-22","2023-11-14","2023-07-24","2023-04-27","2023-04-28","2023-04-27","2023-04-28","2023-04-28","2023-03-28","2023-04-28","2023-04-28","2023-04-27","2023-04-27","2023-04-28","2023-05-03","2025-08-19","2025-08-19","2025-09-11","2024-11-08","2025-08-18","2023-03-28","2023-03-28","2023-11-14","2023-11-14"],"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":[["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","NORTRIPTYLINE HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","INCRUSE ELLIPTA","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","TIOTROPIUM BROMIDE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","FLUCELVAX QUAD 2022-2023","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","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":""}]}]}