{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lee A Flood","gend":1,"currentgend":"","add":"14 WAKEFIELD AVE","city":"SACO","state":"ME","zip":"04072","dob":"1959-11-05","age":"","mstatus":"","insh":"10000076930","cliId":"","pno":2077723728,"cno":2076508398,"email":"lflood@outlook.com","ename":"","eno":"","pphy":"GRASSMANN, JEFFREY L","ppno":2078282402,"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":"14 WAKEFIELD AVE","madd2":"","madd3":"","mcity":"SACO","mstate":"ME","mzip":"04072","pcpfaxno":2078741483,"pcpnpi":1750580486,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9XJ8V32QV22","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S63511A","M5450","E663","F32A","M79606","R911","K5900","M25472","S0101XA","M1811","M19131","S63511S","Z981","R200","R29898","R1084","E039","R1030","H16213","H04123","H43393","H02883","R42","R140","M79642","W19XXXA","G8929","M1612","Z6828","F331","M47816","L570","R600","S2242XA","S20302A","W01198A","R051","R002","M5459","G629","R339","Z4889","G894","R7989","Z87891","R6889","M5416","J984","M4608","R053","Z1389","Z1279","S0990XA","N390","Z1231","S199XXA","K219","E785","I10","K760","Z01818","M79605","Z0000","G9511","G549","S0191XD","M25552","Z13220","R059","M79644","L718","Z760","L820","R062","H5203","H524","M5134","M47814","M48061","R2242","K5730","M160","M19171","R2689","G4709","Z79899","E7800","I081","I77810","D2239","L821","R7303","R5383","M5136","R0981","Z03818","F329","Z96691","M7062","H903","I7090","F419","Z98890","I471","I491","I493","Z7189","N310","G834","D171","M19071","K635","Z86010","N3281","Z1211","D125","D1724","G5602","K439","R222","U071","R55","M5030","M47812","R7402","E876","R112","R4182","R197","Z20822","J069","B9789","Z713"],"date":["2025-05-19","2024-04-03","2023-11-28","2023-04-21","2024-04-03","2023-10-25","2023-11-13","2023-12-13","2024-12-19","2025-07-10","2025-06-02","2025-04-03","2023-09-14","2023-01-17","2023-01-17","2024-06-16","2025-08-04","2024-07-29","2025-09-04","2025-09-04","2025-08-26","2023-06-15","2024-09-23","2024-03-02","2024-12-20","2024-12-20","2024-10-23","2025-09-25","2023-11-28","2023-11-28","2024-04-03","2025-04-10","2024-05-03","2023-06-14","2023-06-14","2023-06-14","2024-06-14","2025-02-11","2023-11-09","2022-12-06","2022-12-06","2025-06-02","2025-05-12","2024-06-16","2024-12-19","2024-02-11","2024-07-15","2023-10-25","2024-07-15","2024-02-11","2024-02-22","2024-02-22","2024-12-19","2024-12-18","2025-02-21","2024-12-19","2025-05-19","2025-05-19","2025-05-19","2024-03-02","2025-05-13","2023-12-14","2024-10-30","2023-10-20","2023-10-20","2024-12-27","2025-09-25","2024-10-13","2024-02-11","2025-03-06","2024-04-17","2024-04-17","2024-04-17","2024-02-14","2025-09-04","2025-09-04","2022-12-24","2022-12-24","2022-12-24","2023-12-14","2023-11-13","2025-01-31","2023-02-08","2023-02-08","2023-03-20","2023-01-13","2025-02-11","2024-06-14","2024-06-14","2023-09-29","2023-09-29","2023-08-23","2025-08-04","2023-09-14","2024-12-09","2024-12-09","2023-08-23","2025-05-19","2025-01-31","2024-02-12","2022-10-25","2022-10-12","2022-10-12","2022-09-08","2022-09-08","2022-09-08","2022-08-25","2022-07-31","2022-08-01","2022-06-29","2022-07-05","2022-06-06","2022-06-06","2022-06-09","2022-06-06","2022-06-06","2022-04-11","2022-04-11","2022-03-30","2022-03-28","2022-04-05","2022-04-07","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2022-04-05","2021-12-17","2021-12-17","2021-12-11","2022-01-25"],"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":[["","","DESIPRAMINE HCL","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","IBUPROFEN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","BENAZEPRIL-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","CLINDAMYCIN PHOSPHATE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","DOXAZOSIN MESYLATE","","","Select","Select",""],["","","WEGOVY","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","NITROFURANTOIN MONO-MACRO","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","MINOCYCLINE HCL","","","Select","Select",""],["","","FOSFOMYCIN TROMETHAMINE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","BUPROPION XL","","","Select","Select",""],["","","FLUOROMETHOLONE","","","Select","Select",""],["","","NALOXONE HCL","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","RAMELTEON","","","Select","Select",""],["","","GEMTESA","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","SYNTHROID","","","Select","Select",""],["","","PAXLOVID (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":""}]}]}