{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steven H Burns","gend":0,"currentgend":"","add":"49 GREELEY AVE","city":"BAR HARBOR","state":"ME","zip":"04609","dob":"1953-08-06","age":"","mstatus":"","insh":"10000066232","cliId":"","pno":2072666070,"cno":"","email":"","ename":"","eno":"","pphy":"KANDUTSCH, MARK A","ppno":2072885119,"pcpadd":"10 WAYMAN LN,","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46091625","pcpcounty":"","pcpid":"","pcpname":"CADILLAC FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"49 GREELEY AVE","madd2":"","madd3":"","mcity":"BAR HARBOR","mstate":"ME","mzip":"04609","pcpfaxno":2072888449,"pcpnpi":1194795799,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1TY1V93MG03","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M79662","M9904","S336XXD","S335XXD","M62838","K5289","L578","L821","D1801","L814","M7918","K5190","M9903","M5450","S0501XA","J9811","M533","H353132","Z0100","M160","N3010","R7303","M47818","R9431","R0789","Z566","Z0000","N401","Z87448","M19072","M7071","K529","Z85828","H353131","S0501XD","S0990XA","S3992XA","Z23","Z5189","R338","G5762","R9439","R791","I209","R079","L570","D229","J189"],"date":["2024-05-10","2025-09-04","2025-09-04","2024-07-15","2025-09-04","2023-02-21","2025-06-12","2025-06-12","2023-06-01","2023-06-01","2023-11-16","2025-01-06","2023-02-08","2023-02-08","2022-11-28","2023-10-11","2023-05-01","2025-04-07","2024-10-14","2023-02-23","2025-08-13","2025-07-18","2023-08-04","2023-11-15","2023-11-14","2023-11-14","2024-08-22","2024-08-12","2023-08-18","2024-03-22","2023-12-18","2025-01-06","2025-06-12","2023-10-17","2022-11-30","2023-04-26","2023-04-26","2023-11-06","2024-06-04","2024-08-12","2024-03-06","2023-10-05","2023-10-11","2023-08-17","2023-08-17","2025-06-12","2025-06-12","2025-04-08"],"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":[["","","FINASTERIDE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","ELMIRON","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE ER","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","Select","Select",""],["","","CYCLOSPORINE MODIFIED","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","DIAZEPAM","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","GENGRAF","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","TOLTERODINE TARTRATE ER","","","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":""}]}]}