{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas F Hudson","gend":0,"currentgend":"","add":"136 MAIN ST","city":"COLUMBIA FALLS","state":"ME","zip":"04623","dob":"1955-01-06","age":"","mstatus":"","insh":"10000075980","cliId":"","pno":2075461372,"cno":"","email":"chudson3@roadrunner.com","ename":"","eno":"","pphy":"MORRIS, ERIC D","ppno":2074834502,"pcpadd":"Harrington Family Health Center,50 East Main St","pcpcity":"Harrington","pcpstate":"ME","pcpzip":"04643","pcpcounty":"","pcpid":"","pcpname":"HARRINGTON FAMILY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"136 MAIN ST","madd2":"","madd3":"","mcity":"COLUMBIA FALLS","mstate":"ME","mzip":"04623","pcpfaxno":2074834778,"pcpnpi":1700411980,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6QP9C39WM38","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R748","N400","M2550","R911","R339","L570","L578","L821","K621","R918","I10","R5383","N401","R338","N138","E785","J0100","Z48816","T85191A","Z0189","Z139","D72820","D696","D649","K639","Z01818","M25519","D709","R319","T85738A","R3911","R350","R3912","H33322","H35372","Z09","N132","K5730","M25512","J634","L089","M25612","M159","T8141XA","R61","R509","N3281","Z0000","T83590A","W19XXXA","R933","Z86010"],"date":["2023-09-05","2025-03-19","2023-09-03","2025-01-14","2024-01-16","2024-05-06","2024-05-06","2024-05-06","2024-07-18","2025-01-27","2025-09-10","2023-09-27","2024-10-10","2024-01-23","2024-10-10","2024-11-13","2022-12-29","2025-01-13","2024-08-29","2024-01-12","2024-08-16","2023-09-05","2023-09-05","2024-05-17","2024-05-17","2025-05-04","2025-05-04","2024-11-13","2024-01-11","2024-08-27","2023-10-20","2023-10-20","2023-10-20","2025-03-06","2025-02-04","2024-08-14","2023-09-03","2023-09-03","2025-03-05","2025-01-27","2024-06-28","2025-03-04","2024-09-10","2024-06-28","2023-09-02","2023-09-02","2024-02-14","2025-08-19","2024-08-16","2025-03-05","2024-06-18","2024-06-18"],"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 HCL","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","HYDROXYZINE PAMOATE","","","Select","Select",""],["","","BETHANECHOL CHLORIDE","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","LEVOFLOXACIN","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","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":""}]}]}