{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jack A Meeker","gend":0,"currentgend":"","add":"63 ARROWHEAD RD","city":"Naples","state":"ME","zip":"04055","dob":"1948-07-10","age":"","mstatus":"","insh":"10000088481","cliId":"","pno":2073293361,"cno":"","email":"wssm2@live.com","ename":"","eno":"","pphy":"MOHAN, ELIZABETH A","ppno":2077745816,"pcpadd":"100 GANNETT DR STE C,","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41065900","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"63 ARROWHEAD RD","madd2":"","madd3":"","mcity":"Naples","mstate":"ME","mzip":"04055","pcpfaxno":"","pcpnpi":1952622151,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6YG6RD6XG59","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S161XXA","M542","H35372","H35341","E785","H349","H43393","H34233","H2513","H469","H547","H3581","I082","I700","I639","Z0101","Z0000","Z8673","Z7902","Z87891","Z23","H3561","D1801","D225","L821","L308","I6523","R930","H35373","H18412","H43813","R4182","R079","I6501","H34231","I7789","G458","H5461","E041","R6889","H34232","E042","H34239","M50322","M50323","M47812","J339","Z860101","E7800","Z0001","J3489","Z1211","H348312","Z125","R7309","Z79899","H35371","H47093","Z98890","Z8709","K117","R208"],"date":["2024-06-05","2024-06-05","2024-01-24","2025-07-30","2023-11-06","2023-11-06","2025-07-30","2025-08-15","2025-08-15","2025-09-30","2023-09-18","2024-04-29","2023-10-27","2023-10-27","2025-08-14","2025-05-19","2025-05-14","2023-10-27","2025-08-13","2025-08-13","2024-05-09","2025-05-19","2023-09-20","2023-09-20","2023-09-20","2023-09-20","2025-08-13","2025-09-30","2025-08-15","2025-08-15","2022-12-06","2023-10-27","2023-09-21","2025-09-30","2025-08-13","2025-09-30","2023-11-28","2023-09-18","2025-10-07","2023-05-13","2023-08-31","2025-10-07","2025-09-30","2024-05-23","2024-05-23","2024-05-23","2023-03-30","2024-10-31","2025-05-14","2025-05-14","2023-11-26","2024-10-31","2022-12-12","2023-03-14","2023-08-23","2025-08-13","2025-09-30","2025-09-30","2022-06-14","2022-06-14","2022-06-14","2022-01-25"],"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":[["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","CLINPRO 5000","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","CLOBETASOL PROPIONATE","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2021-22","","","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":""}]}]}