{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Chris G Daniels","gend":0,"currentgend":"","add":"253 NORTH RD","city":"YARMOUTH","state":"ME","zip":"04096","dob":"1950-01-13","age":"","mstatus":"","insh":"10000063418","cliId":"","pno":2076321154,"cno":"","email":"gizdaniels@maine.rr.com","ename":"","eno":"","pphy":"MARTIN, STEPHEN","ppno":2078469013,"pcpadd":"Intermed,259 Main St","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"253 NORTH RD","madd2":"","madd3":"","mcity":"YARMOUTH","mstate":"ME","mzip":"04096","pcpfaxno":2078741483,"pcpnpi":1740249861,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5KJ3W28TR79","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H43812","H524","I959","M5136","M47817","M4316","M25552","D122","Z86010","D124","K5730","I10","H2513","J3489","I480","I7120","Z8719","N189","E785","M109","D696","I129","Z23","Z0000","Z8249","J329","J40","Z125","R062","Z0001","J069","R059","J9811","J0140","R053","R0989","D649","S62639B","S62637A","S6992XA","R7982","N1832","H35031","H43811","Z48812","I712","K2991","R531","R0602","R079","K922","I700","I2510","K921","D6832","D62","I130","I9789","Z95828","I5032","I351","I77810","I719","K635","R918","R600","Z98890","Z8679","R7989","Z7409","J90","N179","K9189","K567","Z4682","K5989","N401","R3912","Z01812","Z01818","R9720","N1830","Z20822"],"date":["2023-09-19","2025-09-03","2025-07-01","2024-06-21","2024-06-21","2024-06-21","2024-06-21","2024-07-31","2024-07-31","2024-07-31","2024-07-31","2025-09-11","2025-09-03","2025-08-27","2025-01-03","2025-06-09","2024-02-12","2023-05-05","2024-11-13","2024-11-13","2024-11-13","2025-07-15","2025-10-29","2023-11-15","2024-02-12","2025-04-30","2025-04-30","2023-11-09","2025-02-20","2024-11-20","2023-03-15","2023-02-19","2024-12-10","2024-06-27","2024-12-10","2024-12-10","2022-11-21","2022-11-21","2022-11-21","2022-11-21","2022-10-11","2022-10-19","2022-09-15","2022-09-15","2022-06-03","2022-07-01","2022-07-01","2022-06-22","2022-06-24","2022-06-22","2022-06-24","2022-06-22","2022-06-22","2022-06-04","2022-06-04","2022-06-09","2022-06-04","2022-06-06","2022-06-06","2022-06-04","2022-06-04","2022-06-04","2022-06-05","2022-06-04","2022-06-03","2022-06-03","2022-06-03","2022-06-03","2022-05-10","2022-05-03","2022-05-02","2022-04-29","2022-04-29","2022-04-29","2022-04-28","2022-04-28","2022-04-26","2022-04-26","2022-04-23","2022-04-11","2021-11-12","2022-01-24","2022-02-06"],"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",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","PFIZER COVID (12Y UP) VAC(EUA)","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","BUMETANIDE","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","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":""}]}]}