{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christopher T Morrill","gend":0,"currentgend":"","add":"79 BOW ST UNIT 4","city":"FREEPORT","state":"ME","zip":"04032","dob":"1963-10-01","age":"","mstatus":"","insh":"10000083700","cliId":"","pno":2078653565,"cno":"","email":"Magickingdom7128@gmail.com","ename":"","eno":"","pphy":"RIDDLEBERGER, JAMES M","ppno":2078282402,"pcpadd":"Martins Point Health Care,331 Veranda St","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04103","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"79 BOW ST UNIT 4","madd2":"","madd3":"","mcity":"FREEPORT","mstate":"ME","mzip":"04032","pcpfaxno":2078282433,"pcpnpi":1114308277,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4J44GK0RR66","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":["G4733","M25562","M25662","R262","R2681","R600","Z01812","F418","H6120","M4722","M25511","M75101","H6122","E785","E1149","R059","B351","M79674","M79675","F32A","J449","I10","F419","B353","F339","M25512","L601","M19041","M50322","M47812","M170","Z96651","M47816","Z0101","Z471","M65341","S63654D","R7989","Z125","Z23","M5412","M75102","L851","S63654A","M50122","M1712","M25561","M79644","Z720","E668","Z122","G8918","Z96652","R4182","Z13228","M542","Z09","Z87891","M79645","S63617A","R531","L918","L84","J0190","J441","J069","Z20822","R0609"],"date":["2024-08-01","2024-10-21","2024-10-21","2024-10-21","2024-10-21","2025-06-26","2024-07-09","2025-09-04","2025-03-16","2025-06-02","2025-06-02","2025-06-02","2024-06-01","2024-12-09","2025-10-28","2024-02-25","2025-03-10","2025-03-10","2025-03-10","2023-06-22","2024-08-01","2023-06-22","2023-06-22","2025-08-19","2023-09-11","2025-01-15","2023-04-03","2024-03-20","2025-01-15","2025-07-23","2024-03-20","2024-05-08","2025-07-23","2024-09-26","2024-11-15","2024-04-26","2024-04-26","2024-02-20","2024-12-09","2024-12-16","2025-09-03","2025-03-17","2025-10-28","2024-03-28","2025-03-15","2024-08-01","2024-03-20","2024-03-20","2023-12-01","2023-12-01","2024-02-07","2024-08-01","2024-11-15","2024-08-01","2023-06-19","2025-01-15","2024-09-13","2024-02-07","2025-05-22","2025-05-22","2024-09-10","2022-09-22","2022-06-15","2021-11-15","2021-11-15","2021-11-14","2021-12-06","2021-12-30"],"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":[["","","GABAPENTIN","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","FLUOXETINE HCL","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","ONDANSETRON HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","NAPROXEN","","","Select","Select",""],["","","EPINEPHRINE","","","Select","Select",""],["","","LOPERAMIDE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","AZITHROMYCIN","","","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":""}]}]}