{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joseph C Sears","gend":0,"currentgend":"","add":"389 GREELEY RD","city":"FREEDOM","state":"ME","zip":"04941","dob":"1952-04-18","age":"","mstatus":"","insh":"10000084446","cliId":"","pno":2075059630,"cno":"","email":"declined@102125.com","ename":"","eno":"","pphy":"BROWN, JASON","ppno":2076218800,"pcpadd":"Augusta Family Medicine,15 Enterprise Dr","pcpcity":"Augusta","pcpstate":"ME","pcpzip":"04330","pcpcounty":"","pcpid":"","pcpname":"AUGUSTA FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"389 GREELEY RD","madd2":"","madd3":"","mcity":"FREEDOM","mstate":"ME","mzip":"04941","pcpfaxno":2076218801,"pcpnpi":1740592658,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7NN4GH0ER01","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R918","I213","R200","I25110","E785","R053","Z0000","N529","C61","J040","Z08","N50819","Z8546","Z87891","R5382","I2510","R5383","R0602","J449","K219","F17200","Z79899","I10","J9811","Z122","Z1389","Z1211","K635","Z86010","R0989","L821","R3581","R058","M47812","M5030","R413","Z9079","F17210","Z0189","M4802","M542","E559","I252","Z0101","H2512","Z961","H04123","H5203","H524","H52223","D120","I358","Z635","Z579","Z1331","D123","S61217A","X58XXXA","R3589","R351","R238"],"date":["2025-01-27","2024-07-03","2023-04-10","2025-01-22","2025-01-22","2023-04-19","2024-10-24","2025-07-18","2025-04-25","2024-04-03","2025-07-18","2023-11-21","2025-07-18","2025-01-02","2025-01-22","2024-08-12","2024-08-12","2024-08-12","2025-09-02","2023-07-11","2025-09-02","2023-07-11","2024-08-12","2024-01-19","2025-01-02","2023-07-18","2023-12-21","2023-12-21","2023-12-21","2023-02-16","2023-10-24","2023-12-12","2023-04-10","2023-07-18","2023-04-10","2024-11-01","2024-09-30","2025-07-18","2023-07-18","2023-07-18","2023-07-18","2023-08-15","2023-04-10","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2025-09-29","2023-12-21","2024-09-10","2025-01-27","2025-01-27","2024-10-24","2023-12-21","2022-10-02","2022-10-02","2022-08-25","2022-08-23","2022-08-23"],"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":[["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","BUDESONIDE-FORMOTEROL FUMARATE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","DESMOPRESSIN ACETATE","","","Select","Select",""],["","","NITROGLYCERIN","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","BREYNA","","","Select","Select",""],["","","ESOMEPRAZOLE MAGNESIUM","","","Select","Select",""],["","","BREO ELLIPTA","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","VALACYCLOVIR","","","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":""}]}]}