{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gary F Mcadam","gend":0,"currentgend":"","add":"17 LUNT DR","city":"WESTBROOK","state":"ME","zip":"04092","dob":"1955-12-31","age":"","mstatus":"","insh":"10000086138","cliId":"","pno":2073328631,"cno":"","email":"garyfmcadam@gmail.com","ename":"","eno":"","pphy":"FRASER, ROBERT J","ppno":2077745816,"pcpadd":"100 FODEN RD. W,SUITE 203","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41066143","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"17 LUNT DR","madd2":"","madd3":"","mcity":"WESTBROOK","mstate":"ME","mzip":"04092","pcpfaxno":2078741483,"pcpnpi":1134206352,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5FQ4NT0MJ68","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","G4733","R059","I10","E785","Z125","N529","S46011A","M19011","G5603","M65342","G8918","F17220","I351","L570","L720","D225","Z85828","G5623","M25541","M25542","G5601","G5602","Z4789","Z0101","R053","N401","R600","M25411","M79621","M25511","K219","G4730","R4182","J329","S46112A","M25512","K449","Z1211","Z860101","R3912","R6889","H18212","M75101","K2100","M7541","L821","L814","S46011D","Z23","H6121","Z136","I700","Z0001","H40013","R0683","Z043","R0781","R0789","Z03818"],"date":["2024-12-24","2023-09-30","2025-04-07","2024-11-20","2025-05-06","2024-12-02","2024-12-02","2024-12-03","2024-12-05","2023-07-21","2023-07-21","2024-10-18","2024-10-18","2025-03-11","2025-04-10","2024-04-09","2024-04-09","2024-04-09","2023-06-07","2023-06-07","2023-06-07","2023-06-15","2023-06-07","2024-12-05","2025-09-16","2025-04-07","2025-05-14","2024-07-09","2024-12-05","2024-12-05","2024-10-18","2025-05-06","2025-05-06","2025-05-06","2025-04-07","2023-03-20","2023-03-20","2025-05-06","2025-05-06","2025-05-06","2025-05-14","2023-02-01","2025-09-18","2024-10-18","2025-05-06","2024-10-18","2023-05-04","2023-05-04","2025-01-24","2023-10-20","2023-10-20","2022-10-17","2022-10-17","2022-09-26","2022-09-01","2022-04-12","2022-03-20","2022-03-20","2022-03-20","2022-01-19"],"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":[["","","OMEPRAZOLE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","VALSARTAN","","","Select","Select",""],["","","PNEUMOVAX 23","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","ADACEL TDAP","","","Select","Select",""],["","","FLUAD QUAD 2021-2022","","","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":""}]}]}