{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas E Getchell","gend":0,"currentgend":"","add":"21 ABIGAIL WAY","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1954-03-29","age":"","mstatus":"","insh":"10000067019","cliId":"","pno":2078838364,"cno":"","email":"t_getchell@yahoo.com","ename":"","eno":"","pphy":"BARR, DOUGLAS","ppno":2077745816,"pcpadd":"100 FODEN RD WEST,STE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":2077806789,"add2":"","add3":"","madd1":"21 ABIGAIL WAY","madd2":"","madd3":"","mcity":"SCARBOROUGH","mstate":"ME","mzip":"04074","pcpfaxno":2078741483,"pcpnpi":1134180359,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6FR0WE4GE15","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25521","M48061","I7143","I4510","I441","E785","R0989","M4316","T700XXA","M1611","Z86711","Z862","M25852","I7140","M160","M5136","M25551","M7021","H25813","Z0101","D3132","H43813","H2513","Z85828","L111","L570","D485","I7121","Z136","I440","M47816","E88819","M5416","I2510","I723","R079","R29898","Z0001","R6889","I4729","I493","I080","I77810","D708","I2699","Z1211","G5681","M19141","D123","K5730","Z980","M5137","M47817","M4317","I088","Z125","Z0000","I6523","M51370","M5126","I491","L298","Z8639","N400","M19049","D709","R778","E7800","M4807","R760","M533","L821","L578","R040","Z23","M67472","M67479","M799"],"date":["2024-08-07","2025-08-04","2025-02-18","2024-12-20","2024-12-20","2024-08-30","2024-02-06","2024-06-20","2023-03-16","2022-12-06","2023-09-05","2022-11-08","2022-11-08","2025-02-03","2022-11-08","2023-04-19","2022-12-20","2024-10-01","2024-12-10","2023-12-26","2023-12-26","2023-12-26","2022-12-23","2024-01-16","2024-01-16","2025-01-22","2024-01-16","2024-04-30","2022-10-14","2023-09-21","2025-08-04","2025-04-02","2024-04-09","2025-01-09","2025-02-18","2023-09-05","2023-09-05","2024-09-11","2023-01-11","2024-09-11","2024-01-04","2024-03-15","2024-03-15","2022-12-20","2022-12-20","2025-01-15","2023-02-21","2023-02-21","2025-01-15","2025-01-15","2025-01-15","2022-12-20","2022-12-20","2025-08-04","2025-02-03","2024-08-30","2024-08-30","2023-12-28","2025-08-04","2025-08-04","2023-09-21","2023-01-13","2023-09-05","2023-09-05","2023-09-05","2023-09-05","2023-09-06","2024-06-24","2024-06-20","2022-08-31","2022-08-31","2022-04-01","2022-04-01","2021-11-29","2021-12-13","2022-02-25","2022-02-25","2022-02-25"],"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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PROCTO-MED HC","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","FLUOROURACIL","","","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":{"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":[]}},{"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":""}]}]}