{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Geoffrey Leighton","gend":0,"currentgend":"","add":"19 WOOD FROG LN","city":"LITCHFIELD","state":"ME","zip":"04350","dob":"1952-08-23","age":"","mstatus":"","insh":"10000071471","cliId":"","pno":2073537151,"cno":"","email":"LEIGHTONimages1@me.com","ename":"","eno":"","pphy":"KNIGHTON, BRIAN K","ppno":2078653491,"pcpadd":"42 MALLETT DRIVE,","pcpcity":"FREEPORT","pcpstate":"ME","pcpzip":"40326760","pcpcounty":"","pcpid":"","pcpname":"FREEPORT MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"19 WOOD FROG LN","madd2":"","madd3":"","mcity":"LITCHFIELD","mstate":"ME","mzip":"04350","pcpfaxno":"","pcpnpi":1700824000,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8KY2XR7VF11","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M5116","M25561","L570","M5450","N401","N138","I10","L02612","S83231A","X58XXXA","M25569","Z1211","S83241A","M4726","M48061","M23204","Z0101","D492","A7749","I444","M79675","L600","E785","R1084","M4316","I2510","M48062","M1711","M47816","L820","R208","J188","Z0000","R609","M5459","I719","N62","I7091","M5126","M5136","G250","D225","K635","R197","S83242A","I252","R4182","F418","B351","G8929","S30861A","Z125","R0602","I088","R6889","Z86010","D122","K5730","F419","I7121","S83231D","Z01818","R079","H903","H9313","M5432","N200","K449","K4090","L219","L814","L821","Z981","R600","I712","I359","I700"],"date":["2023-06-07","2024-12-11","2025-07-16","2022-12-15","2023-08-15","2023-08-15","2025-07-25","2025-01-07","2025-04-03","2025-04-03","2024-08-07","2024-06-07","2025-04-03","2023-04-03","2023-06-07","2025-01-10","2025-07-29","2025-07-16","2025-07-25","2023-06-01","2025-01-07","2025-01-07","2025-05-06","2025-08-07","2023-05-22","2024-02-20","2023-04-19","2025-01-06","2023-01-18","2025-07-16","2025-07-16","2023-05-31","2024-12-10","2024-12-10","2023-01-18","2024-01-20","2024-01-20","2024-01-20","2023-04-19","2023-04-19","2024-05-02","2025-07-16","2024-06-07","2025-08-07","2025-04-03","2025-04-03","2025-04-03","2025-04-03","2025-01-06","2025-01-06","2025-07-04","2024-12-10","2024-01-25","2024-01-25","2023-12-05","2024-06-07","2024-06-07","2025-07-04","2024-02-21","2024-01-20","2025-09-15","2023-05-31","2025-08-08","2024-02-08","2024-02-08","2023-05-22","2025-07-04","2025-07-04","2025-07-04","2024-07-10","2024-07-10","2024-07-10","2023-06-07","2024-05-02","2022-09-20","2022-09-20","2022-09-20"],"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":[["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","PROPRANOLOL HCL","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","TERBINAFINE HCL","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","PAXLOVID","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","PROPRANOLOL HCL ER","","","Select","Select",""],["","","DESONIDE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","BISOPROLOL FUMARATE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","TROSPIUM CHLORIDE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)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":""}]}]}