{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"John J Neish","gend":0,"currentgend":"","add":"156 HOOPER SANDS RD","city":"SOUTH BERWICK","state":"ME","zip":"03908","dob":"1949-09-11","age":"","mstatus":"","insh":"10000064890","cliId":"","pno":6033208834,"cno":"","email":"","ename":"","eno":"","pphy":"ADAMS, TODD","ppno":2076468386,"pcpadd":"York Hospital Internal Medicine of York,277 Post Rd","pcpcity":"Moody","pcpstate":"ME","pcpzip":"04054","pcpcounty":"","pcpid":"","pcpname":"WEBHANNET INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 215","madd2":"","madd3":"","mcity":"MOODY","mstate":"ME","mzip":"04054","pcpfaxno":2076412855,"pcpnpi":1427165778,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9PF0PQ9HE16","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R079","I2510","R001","R531","F330","F411","Z8673","E1151","M79674","M79675","B351","I350","I10","I672","H353221","H353213","H3562","R0789","M25562","R9431","H541213","E119","F5109","H3561","E785","E669","Z6830","H353233","H2513","R4189","G9341","I639","R410","Z20822","H538","R419","G4733","G300","F02B0","M810","R9082","R5383","I6523","I6611","I6622","R29818","H401131","R197","F0390","Z743","I959","F10129","J029","R4182","H353211","H353223","I060"],"date":["2022-12-19","2024-09-26","2024-04-25","2024-04-24","2025-04-17","2025-04-17","2025-09-11","2025-05-02","2025-05-02","2025-05-02","2025-05-02","2025-09-11","2025-09-11","2025-09-11","2024-06-27","2024-06-27","2024-06-27","2022-12-19","2023-02-21","2024-04-25","2025-06-16","2024-10-26","2025-04-17","2024-01-03","2024-01-03","2024-01-03","2024-01-03","2025-06-17","2025-06-17","2023-04-20","2023-02-12","2023-02-12","2023-02-14","2023-02-12","2024-06-27","2024-12-27","2023-02-12","2025-07-17","2025-07-17","2023-04-07","2023-02-12","2023-02-12","2023-02-14","2023-02-14","2023-02-14","2023-02-13","2022-12-08","2024-04-24","2024-04-24","2024-04-24","2024-04-24","2023-01-17","2023-01-18","2023-01-17","2025-01-02","2025-01-02","2022-06-30"],"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":[["","","TRAZODONE HCL","","","Select","Select",""],["","","CARVEDILOL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","DONEPEZIL HCL","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","LATANOPROST","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","ATROPINE SULFATE","","","Select","Select",""],["","","CYCLOPENTOLATE HCL","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","LOPERAMIDE","","","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":""}]}]}