{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Everett M Hall","gend":0,"currentgend":"","add":"35 LINNELL RD","city":"WINDHAM","state":"ME","zip":"04062","dob":"1954-07-13","age":"","mstatus":"","insh":"10000068552","cliId":"","pno":2076506834,"cno":"","email":"mainemulti@aol.com","ename":"","eno":"","pphy":"FRASER, ROBERT J","ppno":2077745816,"pcpadd":"100 FODEN RD. W,SUITE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41066143","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"35 LINNELL RD","madd2":"","madd3":"","mcity":"WINDHAM","mstate":"ME","mzip":"04062","pcpfaxno":2078741483,"pcpnpi":1134206352,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1HC4D43HX88","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1712","I480","I429","R001","I493","I5022","M25511","R202","R55","W19XXXA","M79671","F1120","Z471","G4733","G4731","L570","C44519","L814","L821","C4491","Z043","M160","M25571","J8410","R918","I10","I4891","Z7901","G5603","D485","L738","I358","R42","I4820","R9720","C44612","R3129","M25562","M25462","N179","M5416","Z0101","I5189","I77810","I499","Z01818","I428","M898X1","Z0001","E785","E669","R053","N401","S7002XA","I441","I440","I498","R7303","D649","D7210","R7989","M47816","Z01812","Z23","H6123","R350","R310","K219","F411","I4510","Z8673","Z125","I340","I442","M75121","S3992XA","M19011","M75101","M25411","M79672","M12811","B351","R0683","N529","G478","R030","M4316","M48061","M2540","Z96652","L578","R6889","I776","I471","I4720","J40","F1220","M19071","H6122","H903","I2720","G8918","M4727","Z4802","L231","L299","Z950","D123","K625","K5730","K648","Z1211","D122","S83272A","S83412A","M948X6","L918","M5431","R300","R309","B356","Z0000","E7800","R195","M1990","D225","Z85828","Z20822","Z03818"],"date":["2025-05-14","2025-10-20","2025-10-08","2025-10-08","2025-10-08","2025-10-29","2025-08-26","2024-06-12","2025-09-21","2025-09-21","2023-12-22","2023-08-18","2025-05-27","2025-11-08","2025-07-29","2025-08-12","2024-04-11","2024-03-26","2023-09-06","2024-04-11","2024-03-18","2024-03-18","2025-03-07","2025-06-23","2025-06-23","2025-09-25","2025-02-24","2025-02-24","2025-01-15","2024-03-26","2023-03-09","2025-03-12","2025-02-23","2023-09-11","2025-09-25","2023-11-10","2024-07-23","2025-05-27","2025-02-19","2023-07-06","2023-01-03","2025-01-16","2025-10-29","2025-10-29","2025-03-12","2025-03-24","2025-03-24","2025-08-26","2025-09-25","2025-09-25","2025-09-25","2023-06-06","2025-06-26","2024-03-18","2025-11-05","2025-09-24","2025-09-24","2023-07-28","2023-07-06","2023-07-06","2023-07-06","2023-03-01","2025-04-15","2025-09-25","2023-06-06","2023-06-15","2024-09-24","2025-05-14","2023-08-11","2023-08-11","2023-06-06","2024-06-12","2023-07-05","2023-07-31","2024-11-07","2025-04-15","2025-03-24","2024-11-07","2024-11-07","2023-07-11","2025-08-26","2023-07-11","2025-04-13","2024-06-25","2025-04-13","2025-04-13","2023-01-04","2023-01-04","2023-01-04","2025-05-27","2024-03-26","2023-01-11","2025-11-06","2023-08-03","2023-08-03","2024-03-04","2024-07-11","2025-03-07","2024-06-12","2024-12-23","2025-10-31","2025-05-14","2023-01-03","2024-04-23","2024-04-23","2024-04-23","2025-11-19","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-03","2022-11-10","2022-11-10","2022-11-10","2022-10-13","2022-09-08","2022-07-25","2022-07-08","2022-05-26","2022-04-26","2022-04-26","2022-04-15","2022-03-22","2021-12-08","2021-12-08","2022-01-02","2022-01-11"],"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":[["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","SPIRONOLACTONE","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRAMADOL HCL-ACETAMINOPHEN","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","SACUBITRIL-VALSARTAN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","LAGEVRIO (EUA)","","","Select","Select",""],["","","ELIQUIS","","","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":""}]}]}