{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John E Ring","gend":0,"currentgend":"","add":"178 FRONT ST","city":"Bath","state":"ME","zip":"04530","dob":"1949-05-06","age":"","mstatus":"","insh":"10000059457","cliId":"","pno":2077519061,"cno":"","email":"","ename":"","eno":"","pphy":"SOMMER, JOHN E","ppno":2077984400,"pcpadd":"Martins Point Health Care,114 Bath Rd","pcpcity":"Brunswick","pcpstate":"ME","pcpzip":"04011","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"178 FRONT ST","madd2":"","madd3":"","mcity":"Bath","mstate":"ME","mzip":"04530","pcpfaxno":2078287850,"pcpnpi":1275732364,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7E34W82XR85","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R918","H9319","K7460","R748","K0889","E7800","Z0000","I2510","Z1211","Z860101","K5730","K635","K7469","Z86010","I8510","I25110","I10","Z87891","R911","M7989","Z1289","R162","R161","R188","D649","D696","D120","D122","D123","I8500","K766","K3189","K259","E1165","H9312","D124","K5140","R0602","Z23","Z860100","R001","J939","J8410","R600","L03115","M79605","L03116","R531","L0390","J8489","D62","Z48813","J449","E782","A609","E785","R4182","K7689","K429","Z0101","K922","E119","J029","J069","D61818","K921","N281","H903","H9313","K319","R059","K5790","Z1329","B372","I455","R0789","L989","Z955","R931","R079","J984","I255","R9439","B182","Z8619"],"date":["2025-08-13","2024-08-01","2025-07-12","2023-09-14","2024-10-05","2025-09-12","2025-09-12","2025-09-12","2025-03-11","2025-03-11","2025-03-11","2025-03-11","2025-09-11","2024-08-14","2024-08-14","2024-11-11","2025-07-11","2024-10-24","2024-10-24","2024-10-24","2024-09-26","2025-01-30","2024-10-08","2024-03-22","2025-07-11","2024-03-26","2024-11-12","2024-07-29","2025-03-11","2025-07-11","2025-07-11","2025-07-11","2025-07-11","2025-09-12","2023-03-20","2025-03-11","2024-11-12","2023-11-10","2025-09-12","2024-11-12","2024-11-12","2024-10-24","2024-01-22","2023-10-14","2023-10-13","2023-10-14","2023-10-14","2023-10-15","2023-10-14","2024-01-03","2025-07-11","2023-11-07","2025-08-13","2023-06-23","2024-11-21","2025-03-11","2025-03-11","2025-01-30","2025-07-11","2025-07-14","2025-07-15","2025-07-11","2023-06-21","2023-06-21","2023-08-01","2025-07-10","2024-03-22","2024-01-30","2024-01-30","2025-07-11","2023-08-02","2025-07-11","2024-09-03","2024-03-10","2023-05-24","2023-05-22","2024-11-21","2023-05-24","2023-05-24","2023-05-24","2024-10-24","2023-05-23","2023-05-23","2022-09-09","2022-09-09"],"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":[["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","NADOLOL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","TRUE METRIX BLOOD GLUCOSE MTR","","","Select","Select",""],["","","TRUEPLUS LANCETS","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","TRUE METRIX GLUCOSE TEST STRIP","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","FLUCONAZOLE","","","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":{"indx":[],"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":""}]}]}