{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Kevin Cookson","gend":0,"currentgend":"","add":"32 MONARCH DR","city":"Augusta","state":"ME","zip":"04330","dob":"1952-11-25","age":"","mstatus":"","insh":"10000062026","cliId":"","pno":2076206784,"cno":"","email":"Kcook435@gmail.com","ename":"","eno":"","pphy":"IANTOSCA, AMANDA N","ppno":2073772111,"pcpadd":"789 CENTRAL AVE,","pcpcity":"DOVER","pcpstate":"NH","pcpzip":"38202526","pcpcounty":"","pcpid":"","pcpname":"WINTHROP FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"32 MONARCH DR","madd2":"","madd3":"","mcity":"Augusta","mstate":"ME","mzip":"04330","pcpfaxno":2076243845,"pcpnpi":1598086241,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3Y25UP9HJ78","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","K7460","D61818","Z961","S52571A","K2270","K449","Z9884","S0990XA","Z041","M546","S52501D","X58XXXD","H6123","H9203","S52611A","M542","M25511","W11XXXA","Y92008","S50811A","S50812A","S30811A","R590","H2512","S59901A","M25521","S4991XA","M5030","M47812","M19011","R197","R10813","Z0000","D649","E785","F325","S6291XA","J189","M9901","R519","M9902","D500","S62633D","S3991XA","S3993XA","S299XXA","H2511","S61012A","I2510","S52351D","M19031","S52601D","S6991XA","R748","S62633B","Z1159","R0689","M25531","M25539","R933","S52501A","S52351A","M1811","G4700","K31A19","M25631","D704","F0781","F419","S52501S","X58XXXS","G44201","L299","R6889","K529","K219","Z0101","H903"],"date":["2025-08-09","2025-04-04","2025-03-10","2025-04-01","2023-05-31","2025-04-04","2025-04-04","2025-04-04","2025-10-02","2025-10-02","2025-10-02","2023-09-05","2023-08-15","2023-05-18","2023-05-18","2023-07-18","2025-10-08","2023-05-27","2023-05-31","2023-05-27","2023-05-06","2023-05-06","2023-05-06","2024-10-28","2025-02-25","2023-05-27","2023-05-27","2023-05-27","2023-05-27","2023-05-27","2024-07-08","2024-10-28","2024-10-28","2023-08-10","2024-11-01","2023-08-10","2024-06-25","2023-05-27","2023-12-21","2024-11-06","2024-11-06","2024-11-06","2025-03-10","2025-05-14","2023-05-27","2023-05-27","2023-05-27","2025-03-04","2022-12-26","2023-07-12","2023-06-14","2024-07-08","2023-06-14","2023-07-18","2024-10-16","2025-04-02","2024-10-22","2023-05-27","2024-07-08","2023-05-27","2023-07-25","2023-06-27","2023-07-18","2023-06-27","2024-06-25","2023-07-25","2023-12-06","2024-11-18","2025-10-08","2023-03-21","2023-12-06","2023-12-06","2024-10-09","2024-10-10","2023-10-05","2025-01-31","2025-01-31","2023-10-05","2023-06-22"],"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":[["","","CREON","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","PRAMIPEXOLE DIHYDROCHLORIDE","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","ACETAMINOPHEN-CODEINE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","DICLOFENAC SODIUM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUARIX QUAD 2022-2023","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","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":""}]}]}