{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeremiah D Turner","gend":0,"currentgend":"","add":"4 PILGRIM DR","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1954-07-19","age":"","mstatus":"","insh":"10000069235","cliId":"","pno":2074506555,"cno":"","email":"turner207@live.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":"PO BOX 232","madd2":"","madd3":"","mcity":"Scarborough","mstate":"ME","mzip":"04070","pcpfaxno":2078741483,"pcpnpi":1134206352,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7QY0TJ4GK46","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H353131","Z0001","R262","M25551","Z4789","Z96641","N4232","R6889","C44219","C44319","M160","M1611","Z510","C44212","Z23","D492","D225","L821","Z85828","Z872","C44619","C61","N400","H2512","Z136","D1739","C4441","C4491","I483","M166","C44311","J45909","R4182","C4481","R9720","I4892","E559","G4733","H524","N401","I517","R739","M8588","Z08","Z923","R339","G4719","M795","Z01810","H353130","N410","R399","R300","Z471","L249","Z13220","Z961","R0609","J8489","I4510","Z8546","Z87891","H1131","H33192","H4389","L570","L578","L905","D2272","R062","M5136","M47816","Z125","R350","D1801"],"date":["2024-12-03","2024-11-18","2023-07-26","2023-07-26","2023-07-26","2023-07-27","2023-02-06","2023-01-17","2025-04-25","2025-04-25","2023-01-24","2023-05-11","2024-10-28","2025-08-19","2024-12-16","2025-08-19","2025-08-19","2025-01-14","2025-08-19","2025-08-19","2025-01-14","2024-10-17","2024-08-07","2024-05-28","2023-04-27","2023-05-11","2025-04-18","2025-01-03","2024-08-20","2023-05-12","2024-05-09","2023-05-11","2023-05-11","2024-01-24","2024-10-17","2023-07-18","2024-11-18","2024-08-02","2025-07-10","2024-11-18","2023-06-27","2024-11-18","2024-03-18","2025-01-03","2025-01-03","2024-10-17","2024-04-10","2024-02-06","2023-04-12","2024-01-30","2025-07-28","2025-07-28","2025-07-28","2023-07-27","2023-06-20","2023-10-31","2024-05-28","2022-12-14","2022-12-14","2023-04-12","2023-05-11","2023-05-11","2022-10-14","2022-08-15","2022-08-15","2022-08-03","2022-08-03","2022-08-03","2022-08-03","2022-07-08","2022-07-08","2022-07-08","2022-07-08","2022-07-07","2022-03-30"],"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":[["","","GENTAMICIN SULFATE","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","HAVRIX","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","MODERNA COVID (12Y UP)VAC(EUA)","","","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":""}]}]}