{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stanley E Smith","gend":0,"currentgend":"","add":"68 COUNTRY CLUB DR","city":"AUBURN","state":"ME","zip":"04210","dob":"1953-02-09","age":"","mstatus":"","insh":"10000072849","cliId":"","pno":2077406594,"cno":"","email":"ssmith@pnscctv.com","ename":"","eno":"","pphy":"ROBERTS, ALEXANDRA","ppno":2076573308,"pcpadd":"Family Health Care Associates,190 Stetson Rd","pcpcity":"Auburn","pcpstate":"ME","pcpzip":"04210","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"68 COUNTRY CLUB DR","madd2":"","madd3":"","mcity":"AUBURN","mstate":"ME","mzip":"04210","pcpfaxno":2078345388,"pcpnpi":1033562863,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8R95CA0MA70","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M47816","M47896","F17210","E1169","F17290","I10","F17209","E785","Z933","C20","Z85048","Z125","Z0000","E119","Z87891","E118","R079","G8929","R110","E1140","F32A","Z23","M5450","I200","M5459","K2970","R3129","N329","Z0101","K2980","K3189","Z923","M19011","K319","K2270","M160","Z1211","M25511","I259","Z08","Z9221","M7521","D649","Z79899","M19032","S41102D","T8133XD","L98492","S41102A","Z09","R6889","S41112A","D509","R911","H353132","W11XXXA","Y939","Y929","S199XXA","S0990XA","S3992XA","S299XXA","S51012A","S42402A","M542","M25522","M5136","M5126","D1809","M5386"],"date":["2025-03-07","2025-08-04","2025-07-03","2025-01-14","2023-04-05","2025-08-19","2025-01-14","2024-10-22","2025-11-10","2025-11-10","2025-07-17","2023-04-14","2024-04-23","2025-05-07","2025-07-07","2024-04-23","2025-02-05","2025-08-18","2025-07-10","2025-07-10","2025-07-10","2024-10-22","2025-08-19","2025-01-14","2024-10-22","2025-10-08","2023-08-30","2023-08-30","2023-07-12","2025-10-08","2025-10-08","2025-07-17","2024-10-03","2025-10-08","2025-10-08","2025-01-29","2024-07-29","2024-10-03","2024-12-31","2025-07-17","2025-07-17","2024-11-15","2024-06-24","2023-03-10","2022-09-20","2022-08-31","2022-09-07","2022-08-17","2022-08-31","2022-09-07","2022-06-30","2022-06-28","2022-06-23","2022-06-23","2022-06-24","2022-06-24","2022-06-24","2022-06-24","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2021-12-27","2021-12-27","2021-12-27","2022-01-12"],"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":[["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","NYSTATIN-TRIAMCINOLONE","","","Select","Select",""],["","","SOD SULF-POTASS SULF-MAG SULF","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}