{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"M P Ohara","gend":1,"currentgend":"","add":"126 ANGLERS RD","city":"WINDHAM","state":"ME","zip":"04062","dob":"1954-12-21","age":"","mstatus":"","insh":"10000073366","cliId":"","pno":2073183232,"cno":"","email":"declined@111220.com","ename":"","eno":"","pphy":"PANOZZO, SHASHI T","ppno":2078469013,"pcpadd":"100 GANNETT DR STE C,","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41065900","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 1835","madd2":"","madd3":"","mcity":"WINDHAM","mstate":"ME","mzip":"04062","pcpfaxno":2075238586,"pcpnpi":1255301701,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8Q13KX9CE02","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M1611","I82502","Z7901","Z01818","F5101","F331","F410","H8111","G9389","I6782","F330","F5104","M1612","E669","Z6839","Z0101","I480","I350","M7062","M65842","M1812","F3342","F411","Z1231","E785","E6601","Z6841","R42","Z471","T50905S","Z96641","R4189","Z96642","F4312","M19072","M19071","M2142","M2141","I10","F413","Z23","E041","Z0001","F418","K219","M25552","E213","E042","M25532","R1013","R634","A000","R251","D6859","M160","U071","Z9189","M25551","F341","R1031","M533","M47816","Z0000","R7309","L710","M5430","M5416","M4726","M4316","J029","Z03818","J069"],"date":["2023-03-16","2022-12-13","2024-01-03","2024-08-26","2025-08-12","2025-08-12","2025-07-15","2023-06-02","2024-10-22","2024-10-22","2025-02-12","2023-04-20","2024-09-20","2024-09-20","2024-09-20","2025-05-09","2024-08-05","2024-08-15","2024-06-13","2025-04-04","2025-04-04","2023-08-09","2025-08-12","2025-05-16","2025-03-03","2023-02-28","2023-02-28","2023-05-11","2024-11-13","2025-08-12","2023-04-26","2024-09-17","2024-10-04","2022-12-15","2025-02-12","2025-02-12","2025-02-12","2025-02-12","2025-03-03","2025-05-27","2024-11-21","2024-02-20","2025-03-12","2024-09-20","2024-09-20","2024-06-13","2024-01-03","2024-02-20","2025-03-12","2024-11-21","2024-11-21","2023-03-05","2023-05-11","2023-11-16","2022-10-26","2022-09-27","2022-05-20","2022-05-20","2022-05-25","2022-04-29","2022-04-11","2022-04-11","2022-03-18","2022-03-08","2021-11-22","2022-01-20","2022-02-10","2022-02-10","2022-02-10","2022-02-22","2022-02-22","2022-02-21"],"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":[["","","LORAZEPAM","","","Select","Select",""],["","","ATENOLOL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","HYDROXYZINE PAMOATE","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","TRINTELLIX","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","MINOCYCLINE HCL","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2022-23","","","Select","Select",""],["","","CARTIA XT","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","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":""}]}]}