{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"William P Simpson","gend":0,"currentgend":"","add":"80 BELL ST","city":"PORTLAND","state":"ME","zip":"04103","dob":"1957-07-23","age":"","mstatus":"","insh":"10000097293","cliId":"","pno":2078740700,"cno":"","email":"CLASSACTSPROPERTYMANAGEMENT@YAHOO.COM","ename":"","eno":"","pphy":"ODONNELL, PETER B","ppno":2078462229,"pcpadd":"Harbourside Family Practice,60 Forest Falls Dr Ste 3","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"HARBOURSIDE FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 10250","madd2":"","madd3":"","mcity":"PORTLAND","mstate":"ME","mzip":"04104","pcpfaxno":2078465119,"pcpnpi":1982649943,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2RJ2M21AJ02","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I9751","I469","K661","I4891","R030","Z4889","S36209A","K750","R509","K668","Z4682","J90","R600","F4322","I480","Z48812","Z515","Z7189","J9600","Z9189","S36113D","J9601","K8050","G4733","D72829","J9811","G8918","M9900","M9901","M9902","R140","R918","I7120","I340","I4819","R0789","R262","Z736","M21611","A498","R578","Z933","R6339","R571","Z125","E7800","I10","M5450","R200","K9181","K2289","Z0100","M7981","S36039A","D7589","S21101A","K9189","F419","K810","K55049","I82613","I82C11","K625","K648","K769","K631","Z98890","M96831","Y838","I3139","R1902","J45909","Z0001","R109","K559","I498","E785","Z433","Z23","I77819","R079","R0683","I314","I9788","K316","I82611","R58","S36209S","M19071","M2011","I3489","I77810","J40","J329","I080","K651","Z1211","K5140","K5289","S3991XA","S3993XA","A419","T8143XA","R202","L988","K219","R4182","H9201","I499","K635","K529","Z7901","Z1389","R799","R2243","T8119XA","S36113A","T79A3XA","D7822","J209","R031","R634","S2609XA","S27331A","Y658","G479","I712","R059","Z8709","S76312A","Z0000"],"date":["2024-10-09","2025-08-22","2024-11-04","2025-02-20","2024-03-15","2025-10-31","2025-01-21","2025-09-11","2025-05-23","2025-10-02","2024-10-21","2024-10-29","2024-10-18","2025-03-13","2025-03-13","2024-11-16","2024-11-04","2024-10-25","2024-10-24","2024-11-14","2024-10-22","2024-11-14","2024-10-24","2023-12-25","2024-10-17","2024-10-31","2025-10-02","2024-11-07","2024-11-07","2024-11-07","2024-10-21","2024-10-19","2023-12-26","2024-10-14","2025-05-01","2025-02-11","2024-11-17","2024-11-17","2024-08-07","2024-10-22","2024-10-22","2025-09-30","2025-01-21","2024-10-24","2023-07-11","2023-07-18","2024-10-01","2023-12-12","2023-12-12","2025-01-30","2025-01-30","2025-09-04","2024-10-19","2024-10-09","2024-10-22","2024-10-14","2024-10-14","2025-09-09","2024-10-11","2024-10-11","2024-10-18","2024-10-18","2025-10-31","2025-10-31","2024-10-31","2025-09-23","2024-10-31","2024-10-29","2024-10-29","2024-11-04","2024-11-05","2025-08-27","2024-10-01","2024-11-12","2024-10-11","2025-02-20","2025-08-27","2025-10-02","2024-10-01","2023-10-16","2024-10-29","2023-04-10","2024-10-14","2024-10-14","2025-02-05","2024-12-31","2025-02-04","2025-01-28","2024-08-07","2024-08-07","2024-02-14","2024-02-14","2024-02-12","2024-02-12","2023-09-27","2025-01-21","2025-08-27","2025-08-27","2025-08-27","2024-12-27","2024-12-27","2024-12-27","2024-12-27","2023-01-31","2023-01-31","2025-01-03","2025-01-03","2025-06-30","2023-09-27","2025-08-27","2025-08-27","2023-08-03","2025-06-16","2024-12-05","2024-10-15","2024-10-09","2024-10-09","2024-10-09","2024-10-09","2023-04-25","2024-12-17","2024-12-17","2024-10-11","2024-10-11","2024-10-11","2022-10-20","2022-08-30","2022-08-02","2022-08-02","2022-07-07","2022-07-05"],"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":[["","","OXYCODONE HCL","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","DIGOXIN","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","METRONIDAZOLE","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","AZITHROMYCIN","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","NEOMYCIN SULFATE","","","Select","Select",""],["","","ALPRAZOLAM","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","METOCLOPRAMIDE HCL","","","Select","Select",""],["","","PENICILLIN V POTASSIUM","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","ADVAIR DISKUS","","","Select","Select",""],["","","COMIRNATY 2023-2024","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","ABRYSVO","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","VENTOLIN HFA","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PFIZER COVID BIVAL (12Y UP)EUA","","","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":""}]}]}