{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Scott B Hughes","gend":0,"currentgend":"","add":"24 STONY BROOK WAY","city":"BAR HARBOR","state":"ME","zip":"04609","dob":"1956-09-29","age":"","mstatus":"","insh":"10000090932","cliId":"","pno":2072889935,"cno":2074581363,"email":"Scotthughes484@gmail.com","ename":"","eno":"","pphy":"WEISS, ROBERT D","ppno":2073389968,"pcpadd":"PO BOX 8,10 WAYMAN LANE","pcpcity":"BAR HARBOR","pcpstate":"ME","pcpzip":"46090008","pcpcounty":"","pcpid":"","pcpname":"COOPER GILMORE HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"24 STONY BROOK WAY","madd2":"","madd3":"","mcity":"BAR HARBOR","mstate":"ME","mzip":"04609","pcpfaxno":2073380332,"pcpnpi":1538150503,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"9FM3H03XM07","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E038","K1321","K900","L570","L578","Z85828","L821","D485","M818","R0989","Z23","D638","Z0000","Z2821","M47816","L219","L989","R911","H6123","R059","R6889","D044","Z0100","I2510","E785","Z87891","E039","Z79890","Z8781","Z7982","Z7185","J3089","R490","K219","M533","L218","Z5189","M5459","D539","D696","B6001","N1830","M810","R1115","J438","B89","D649","I10","J310","M461","M8589","S0100XA","N170","J439","Z13820","R531","M5416","J4489","R0683","S32000A","R7303","G479","K5730","Z801","H6590","H6091","M7910"],"date":["2025-04-16","2025-04-24","2025-07-08","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-07-01","2025-07-25","2023-07-20","2023-11-09","2023-09-15","2025-03-31","2023-05-25","2025-07-21","2024-01-05","2024-01-05","2024-03-13","2022-10-12","2022-10-12","2023-09-18","2025-08-14","2025-07-09","2023-09-15","2023-09-15","2025-04-04","2025-07-08","2023-08-07","2023-08-07","2023-08-07","2023-11-03","2024-10-02","2023-10-18","2024-04-17","2024-10-22","2024-12-30","2024-10-03","2024-10-22","2024-07-24","2024-07-24","2024-08-25","2024-03-29","2025-03-18","2024-10-31","2024-08-14","2024-07-09","2024-09-30","2025-04-01","2023-04-18","2025-02-11","2025-02-05","2024-05-30","2024-07-09","2024-07-07","2025-02-05","2024-07-03","2024-12-13","2024-10-09","2024-12-04","2023-03-17","2023-03-17","2023-03-17","2024-10-27","2024-10-09","2022-09-06","2022-08-27","2022-08-12"],"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":[["","","KETOCONAZOLE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","IPRATROPIUM BROMIDE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","FAMOTIDINE","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","AZELASTINE HCL","","","Select","Select",""],["","","ATOVAQUONE","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ALENDRONATE SODIUM","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","MODERNA COVID BIVAL(6MO UP)EUA","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-HYDROCORT","","","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":""}]}]}