{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joel P Porter","gend":0,"currentgend":"","add":"34 MOUNTAIN VIEW RD","city":"NORTH WATERBORO","state":"ME","zip":"04061","dob":"1953-09-22","age":"","mstatus":"","insh":"10000091653","cliId":"","pno":2074675917,"cno":"","email":"jporter19972@roadrunner.com","ename":"","eno":"","pphy":"BATES, GREGORY K","ppno":2078399101,"pcpadd":"Northern Light Mercy Health Center,409 Roosevelt Trl","pcpcity":"Windham","pcpstate":"ME","pcpzip":"04062","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"34 MOUNTAIN VIEW RD","madd2":"","madd3":"","mcity":"NORTH WATERBORO","mstate":"ME","mzip":"04061","pcpfaxno":2078399201,"pcpnpi":1487022398,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5ND2F08QP01","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":["L720","Z98890","Z96612","M25511","H2511","M75112","H02831","H02834","Z8739","Z87891","Z4789","S40262A","W57XXXA","M75121","I4891","R569","H2512","E782","G40009","G40409","Z0000","G40802","M7500","I25110","M7551","H2513","I69898","R300","G8918","I10","E785","Z0101","H5203","M549","M19011","R0683","Z01818","H02403","M25611","Z961","Z09","M75100","I480","Z01810","M75111","H53453","M19012","M7502","M75101","R739","Z7689","R319","R29898","R4182","Z23","Z951","Z7901","L03115","Z8673","I69398","H5347","Z0001","J069","Z136","M7521","R9401","R404","G8191","I6522","M25612","H53462","Z7982","R6889","G9389","H524"],"date":["2022-12-20","2025-06-03","2024-01-30","2025-07-15","2025-01-09","2023-10-13","2025-11-04","2025-11-04","2024-11-12","2025-01-03","2025-03-21","2025-04-21","2025-07-21","2025-09-08","2024-06-07","2024-06-05","2025-01-09","2024-12-10","2024-10-31","2023-06-01","2025-06-18","2024-03-14","2024-10-01","2024-12-06","2025-07-21","2024-10-28","2024-10-28","2023-11-12","2025-01-22","2023-10-13","2023-10-13","2024-05-29","2024-05-29","2024-11-12","2024-11-12","2025-01-22","2024-04-20","2025-11-04","2023-02-08","2025-01-09","2023-05-26","2024-09-17","2025-10-30","2025-10-30","2024-06-07","2025-02-03","2023-10-13","2023-10-13","2025-01-22","2023-09-29","2025-06-11","2023-12-23","2023-05-24","2023-05-24","2023-09-29","2025-01-03","2023-05-04","2025-07-21","2023-11-01","2023-01-25","2023-01-25","2023-12-13","2025-01-03","2024-12-06","2025-09-08","2022-10-31","2022-10-31","2022-11-23","2022-10-24","2022-10-21","2022-08-24","2022-08-24","2022-07-19","2022-08-01","2022-06-23"],"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":[["","","ZONISAMIDE","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","NEOMYCIN-POLYMYXIN-DEXAMETH","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","MELOXICAM","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","LEVETIRACETAM","","","Select","Select",""],["","","LAMOTRIGINE","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","DIVALPROEX SODIUM","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}