{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Harold F Parker","gend":0,"currentgend":"","add":"12 EIDER RD","city":"Harpswell","state":"ME","zip":"04079","dob":"1945-10-07","age":"","mstatus":"","insh":"10000079096","cliId":"","pno":2077519032,"cno":"","email":"Parkerjr45@gmail.com","ename":"","eno":"","pphy":"DECK, MARCUS M","ppno":2077984400,"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":"12 EIDER RD","madd2":"","madd3":"","mcity":"Harpswell","mstate":"ME","mzip":"04079","pcpfaxno":2077984018,"pcpnpi":1891717872,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4Q20J02WY39","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":["Z0000","F900","F419","Z0100","M25512","D649","I214","G4733","M810","I2510","I480","E7800","I10","M25562","K5900","Z87891","R6889","R350","M25551","H40013","M19012","R059","R2242","G4730","B372","M25062","M25462","R053","R918","R42","M75102","S46112A","Z13228","E785","Z954","I471","K219","Z23","K861","K869","Z951","Z7902","Z48812","I25110","Z20822","R0789","R0602","R5383","R2689","R079","Z98890","I4891","J9811","J90","R9431","I209","I255","I200","R202","M25531","J342","K429","K56609","I340","Z743","M25532","K8689","Z01810"],"date":["2024-10-04","2025-10-07","2025-10-07","2025-10-30","2023-09-25","2022-11-28","2023-03-01","2025-10-01","2025-05-27","2024-07-19","2024-07-19","2024-07-19","2025-07-03","2025-02-19","2025-07-03","2025-07-03","2023-05-01","2023-10-24","2024-05-29","2025-10-30","2023-09-25","2025-11-06","2025-03-04","2024-07-02","2025-08-02","2025-02-15","2025-02-15","2025-03-03","2025-03-03","2025-02-15","2023-09-25","2023-09-25","2025-05-27","2025-05-27","2022-12-02","2023-08-22","2023-05-17","2022-11-16","2022-11-23","2022-11-23","2022-11-23","2022-11-23","2022-11-07","2022-10-02","2022-10-02","2022-10-20","2022-10-20","2022-10-20","2022-10-05","2022-10-21","2022-10-21","2022-10-21","2022-10-02","2022-10-05","2022-09-20","2022-09-20","2022-09-20","2022-09-28","2022-09-25","2022-09-25","2022-09-29","2022-09-29","2022-09-29","2022-09-29","2022-09-26","2022-09-15","2022-09-28","2022-09-27"],"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":[["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","MNEXSPIKE 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","AZELASTINE-FLUTICASONE","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","NITROGLYCERIN","","","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":""}]}]}