{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas G Difiore","gend":0,"currentgend":"","add":"8 CASCO TER APT 12","city":"FALMOUTH","state":"ME","zip":"04105","dob":"1963-02-15","age":"","mstatus":"","insh":"10000084635","cliId":"","pno":2076157996,"cno":"","email":"tdifiore02@gmail.com","ename":"","eno":"","pphy":"GREIL, JENNER E","ppno":2078282402,"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":"8 CASCO TER APT 12","madd2":"","madd3":"","mcity":"FALMOUTH","mstate":"ME","mzip":"04105","pcpfaxno":2078287850,"pcpnpi":1871748772,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8MV2N89FW01","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":["E871","J9811","K219","F419","Z23","F332","L74519","R0600","M5450","R262","F411","R070","F458","F413","Z789","F450","K8689","R0982","Z9109","F1090","F410","Z86010","I6523","R079","R093","R634","T280XXA","K5730","K648","Z980","K5710","G4700","R739","H9313","R221","N401","N486","R4589","R0981","Z87891","F333","F17210","R5381","Z72820","R531","F10929","R251","R6889","R002","R6883","F451","F489","R45851","Z13220","Z1211","F1010","R253","J392","Z8509","F10930","I493","J310","J343","T485X5A","G250","R0789","E8809","Z743","R0609","Z720","G521","E785","R0602","M9901","M5412","D3A00","Z125","R197","R779","T402X2A","Z85038","T391X2A","R4182","Z91048","Z0189","G4709","R61","D374","L74510","E8352","G522","M9902","M5414","F331","I498","C7A029","K5900","K6389","E559","R140","D890","Z86012","R194","E7800","Z13228","R309","R109","G8929","Z79899","M5416","S76011D"],"date":["2025-06-02","2025-08-12","2023-05-12","2025-03-02","2025-10-15","2025-10-16","2025-02-11","2024-01-11","2023-04-20","2023-04-20","2025-10-16","2025-07-16","2023-08-25","2025-04-03","2025-03-13","2025-03-13","2024-01-30","2023-12-16","2023-07-17","2025-10-16","2025-10-16","2023-10-24","2023-12-21","2025-04-08","2023-11-02","2025-04-02","2023-11-02","2023-10-24","2023-10-24","2023-10-24","2023-05-24","2025-03-02","2025-03-05","2023-12-21","2023-12-21","2023-12-01","2023-12-01","2023-12-16","2023-12-16","2025-02-26","2025-03-02","2025-08-12","2025-06-12","2025-02-28","2025-08-12","2025-02-26","2025-02-26","2023-04-06","2025-04-23","2025-02-15","2025-02-25","2025-02-25","2025-02-25","2025-03-03","2023-10-24","2025-02-26","2025-02-17","2023-04-25","2023-10-06","2025-08-12","2025-05-08","2022-12-28","2022-12-28","2022-12-28","2024-08-21","2025-04-23","2024-07-30","2025-02-18","2025-08-27","2025-08-27","2025-09-10","2025-06-02","2025-08-12","2025-07-03","2025-07-03","2023-08-25","2023-10-10","2023-08-31","2024-01-16","2024-01-20","2024-08-23","2024-01-22","2024-01-22","2023-07-17","2025-06-11","2023-07-24","2025-06-02","2023-01-10","2025-06-16","2025-06-05","2023-07-19","2024-02-05","2024-02-05","2025-02-20","2025-05-08","2023-01-10","2023-01-10","2023-01-10","2023-07-07","2023-10-06","2024-09-11","2023-07-13","2023-06-23","2023-09-15","2025-03-03","2023-10-16","2024-01-11","2023-09-11","2023-09-11","2022-09-01","2022-09-01"],"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":[["","","AZELASTINE HCL","","","Select","Select",""],["","","CLONAZEPAM","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","DOXEPIN HCL","","","Select","Select",""],["","","QUETIAPINE FUMARATE","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","CREON","","","Select","Select",""],["","","CHLORDIAZEPOXIDE HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","ZOLPIDEM TARTRATE","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","NYSTOP","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","ARIPIPRAZOLE","","","Select","Select",""],["","","MIRTAZAPINE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","MOMETASONE FUROATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","LIDOCAINE HCL VISCOUS","","","Select","Select",""],["","","LANSOPRAZOLE","","","Select","Select",""],["","","SUCRALFATE","","","Select","Select",""],["","","CARBAMAZEPINE","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","ZENPEP","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","PREDNISONE","","","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":""}]}]}