{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jeffrey S Wheeler","gend":0,"currentgend":"","add":"7 HEATHWOOD LN","city":"SCARBOROUGH","state":"ME","zip":"04074","dob":"1953-11-24","age":"","mstatus":"","insh":"10000083275","cliId":"","pno":2532789303,"cno":"","email":"jwheeler11@hotmail.com","ename":"","eno":"","pphy":"OSULLIVAN, SEAN T","ppno":2078282433,"pcpadd":"76 High St Fl 1,","pcpcity":"Lewiston","pcpstate":"ME","pcpzip":"04240","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"565 SHEEP CREEK RD","madd2":"","madd3":"","mcity":"Battle Mountain","mstate":"NV","mzip":"89820","pcpfaxno":2078282433,"pcpnpi":1285073205,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2YM4Y45WC79","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I959","I999","E1165","I255","I5022","I2102","K254","I5021","J9601","Q401","K2090","K2970","K921","D62","J189","R0600","R0603","I5042","I3489","I213","I4720","I440","I5189","I2510","L089","M19071","R002","K047","I4891","K760","K5730","K4090","E8720","I480","N179","Z139","J0190","R079","E785","I509","I10","Z955","I252","K029","R059","R197","I371","I4811","I088","I2720","R0602","R053","L03032","Q5310","R042","S61210A","N433","N503","I4519","J209","T5691XD","M542","G35","Z79899","E119","R7879","K594","Z20822","K121","R2243"],"date":["2023-10-30","2024-05-10","2024-06-10","2025-06-11","2024-06-18","2022-12-13","2022-12-13","2022-12-13","2022-12-13","2022-12-12","2022-12-12","2022-12-12","2025-04-22","2022-12-13","2022-12-08","2023-04-18","2022-11-29","2024-07-19","2022-12-09","2022-12-09","2025-03-18","2025-06-11","2024-10-10","2025-06-11","2025-06-20","2025-06-20","2024-04-19","2023-09-26","2024-06-18","2024-04-17","2024-04-17","2024-04-17","2024-05-10","2025-02-19","2023-08-09","2023-08-09","2023-03-23","2025-07-25","2025-01-27","2024-04-16","2024-04-16","2025-06-11","2025-06-11","2024-05-10","2022-11-29","2023-05-03","2023-06-05","2023-06-12","2024-10-11","2024-10-11","2022-12-08","2025-04-22","2025-06-27","2022-11-10","2023-06-03","2024-02-10","2022-11-10","2022-11-10","2023-06-16","2023-06-07","2022-10-19","2022-10-19","2022-10-19","2024-09-19","2024-03-20","2022-09-01","2022-09-01","2022-07-26","2022-06-30","2022-06-30"],"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":[["","","SPIRONOLACTONE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","FARXIGA","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","DIGOXIN","","","Select","Select",""],["","","ONETOUCH VERIO FLEX METER","","","Select","Select",""],["","","EPLERENONE","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","ONETOUCH VERIO TEST STRIP","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}