{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stephen H Donovan","gend":0,"currentgend":"","add":"504 SEBASCO RD","city":"PHIPPSBURG","state":"ME","zip":"04562","dob":"1954-02-17","age":"","mstatus":"","insh":"10000075843","cliId":"","pno":2077495660,"cno":"","email":"dnvn@maine.rr.com","ename":"","eno":"","pphy":"PHAN, ANDREW T","ppno":2078282402,"pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"504 SEBASCO RD","madd2":"","madd3":"","mcity":"PHIPPSBURG","mstate":"ME","mzip":"04562","pcpfaxno":2078287850,"pcpnpi":1619918307,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6P59W58CJ41","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M170","M1712","A000","H524","H35363","M25662","R531","M25562","R2689","E669","G8918","K429","G4733","Z13228","E782","Z1211","G629","Z471","Z01818","Z96651","E663","Z87891","R918","Z96652","Z13220","Z136","D225","L814","L821","L568","Z125","E66811","K219","M159","E785","G4730","G609","M179","F5221"],"date":["2024-01-11","2024-01-22","2024-01-23","2023-07-13","2023-07-13","2024-04-15","2024-04-15","2024-04-15","2024-04-15","2024-01-22","2024-01-22","2025-10-28","2025-11-05","2025-04-23","2025-04-23","2025-06-10","2023-05-12","2024-03-20","2023-12-11","2024-01-11","2025-06-03","2025-10-07","2025-05-22","2024-02-05","2023-02-06","2023-02-06","2024-12-19","2024-12-19","2024-12-19","2024-12-19","2024-04-30","2025-02-24","2024-06-10","2024-06-10","2025-10-07","2025-10-07","2022-08-25","2022-08-25","2022-08-25"],"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":[["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CELECOXIB","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","ETODOLAC","","","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":{"indx":[["","","","",""],[""],[""],[""],[""],[""]],"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":""}]}]}