{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stephen C Williams","gend":0,"currentgend":"","add":"156 PINEWOODS RD","city":"LISBON","state":"ME","zip":"04250","dob":"1955-01-14","age":"","mstatus":"","insh":"10000062380","cliId":"","pno":2077540797,"cno":"","email":"VEGA73@HOTMAIL.COM","ename":"","eno":"","pphy":"STADNICKI, MICHAEL R","ppno":2077537655,"pcpadd":"12 HIGH ST,STE 302","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407634","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"156 PINEWOODS RD","madd2":"","madd3":"","mcity":"LISBON","mstate":"ME","mzip":"04250","pcpfaxno":2077537656,"pcpnpi":1831179803,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9EH3D09YD77","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M65251","I7143","Z136","H25812","H25811","N529","B081","M5136","M5137","M779","M160","E871","E118","N401","Z0000","M25559","M549","I719","D638","R040","E11621","L97519","E1140","M79606","C44319","I7140","F4323","T148XXA","F331","F411","F528","F1220","R238","R208","L0889","N390","R339","E119","F419","Z630","E1122","N10","L98499","L84","I10","L821","D485","N1830","M47816","M5459","E7800","R6889","H2513","H40013","R809","H25813","R079","K219","R0789","I700","I351"],"date":["2023-11-16","2024-02-16","2024-02-16","2025-08-19","2025-08-05","2025-11-07","2024-08-22","2023-06-14","2023-06-14","2023-06-14","2023-06-14","2023-09-27","2025-09-19","2025-11-07","2025-09-22","2023-05-31","2023-05-31","2023-11-03","2025-03-03","2023-05-31","2025-11-13","2025-10-22","2025-10-22","2025-10-22","2025-03-27","2025-10-10","2025-02-12","2025-01-27","2025-01-17","2025-02-11","2025-01-17","2025-01-17","2024-08-22","2024-08-22","2024-08-22","2024-10-21","2024-12-18","2025-06-23","2024-12-23","2024-12-23","2025-03-13","2024-03-11","2023-03-20","2023-03-13","2025-03-03","2024-07-17","2024-07-17","2025-03-13","2023-11-03","2023-11-03","2023-09-27","2023-09-13","2025-06-23","2025-06-23","2023-09-27","2025-07-21","2022-08-17","2022-08-17","2022-08-24","2022-08-17","2022-08-17"],"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":[["","","METFORMIN HCL ER","","","Select","Select",""],["","","FREESTYLE LIBRE 3 READER","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","LANSOPRAZOLE","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","HYDROXYZINE PAMOATE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","FREESTYLE PRECISION NEO","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","DAPAGLIFLOZIN","","","Select","Select",""],["","","CEFPODOXIME PROXETIL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","FREESTYLE LIBRE 2 SENSOR","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","GLIPIZIDE","","","Select","Select",""],["","","NITROGLYCERIN","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}