{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James D Mackenzie","gend":0,"currentgend":"","add":"79 CASH ST","city":"SOUTH PORTLAND","state":"ME","zip":"04106","dob":"1955-06-05","age":"","mstatus":"","insh":"10000099762","cliId":"","pno":2076324757,"cno":"","email":"DUNCAN.MACKENZIE9@GMAIL.COM","ename":"","eno":"","pphy":"KNIGHTON, BRIAN K","ppno":2078653491,"pcpadd":"42 MALLETT DRIVE,","pcpcity":"FREEPORT","pcpstate":"ME","pcpzip":"40326760","pcpcounty":"","pcpid":"","pcpname":"FREEPORT MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"79 CASH ST","madd2":"","madd3":"","mcity":"SOUTH PORTLAND","mstate":"ME","mzip":"04106","pcpfaxno":"","pcpnpi":1700824000,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4WR6M32UC43","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M9907","S53492A","Z0000","Z125","E785","B351","M79671","J0190","R7301","N132","N201","N135","R6889","M25511","N200","K219","E039","R4182","Z0100","M25522","Z01818","N202","R3589","M7910","Z87891","Z79899","Z466","N2889","D489","H9190","R059","J189","Z87442","R7401","H903","J0101","R7303"],"date":["2022-12-12","2022-12-12","2024-11-12","2025-04-25","2023-07-03","2024-12-04","2024-12-04","2025-01-22","2023-11-08","2023-03-26","2023-06-01","2023-05-12","2023-12-08","2025-04-29","2024-06-28","2023-05-12","2023-07-03","2023-03-26","2024-10-09","2023-02-06","2023-06-01","2023-07-03","2023-05-22","2023-05-18","2023-05-12","2023-05-12","2023-07-11","2023-07-03","2023-11-08","2023-11-08","2024-01-01","2024-01-05","2023-10-25","2025-04-25","2024-03-05","2023-10-02","2025-07-08"],"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":[["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","DICLOFENAC POTASSIUM","","","Select","Select",""],["","","FLUOROURACIL","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","PREVNAR 20","","","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":""}]}]}