{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Bernard J Broder","gend":0,"currentgend":"","add":"249 EAST SHORE DR","city":"ACTON","state":"ME","zip":"04001","dob":"1957-12-17","age":"","mstatus":"","insh":"10000100318","cliId":"","pno":2078997868,"cno":"","email":"attorneybroder@yahoo.com","ename":"","eno":"","pphy":"CORNELIO, MARCO C","ppno":2072831441,"pcpadd":"PO BOX 99,","pcpcity":"LINCOLN","pcpstate":"ME","pcpzip":"44570099","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"249 EAST SHORE DR","madd2":"","madd3":"","mcity":"ACTON","mstate":"ME","mzip":"04001","pcpfaxno":2077946777,"pcpnpi":1902125909,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5K09FK7HD51","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":["D492","R079","R3129","G245","F331","L989","D0339","C44622","L820","C44719","L570","D225","L821","L578","R197","K5010","K5090","K219","E785","R4182","Z79899","M25561","Z23","R42","R110","R5383","R300","D2239","D2372","Z85820","N451","L905","M79662","K5000","Z85828","M1711","Z131","L219","E669","K5730","K648","K2970","R1084","N281","K769","R109","R319","G2581","Z0101","H16223","M23261","R531","A549","Z136","Z13220","I358","L814","Z299"],"date":["2025-06-27","2024-08-20","2025-11-06","2025-09-03","2025-10-30","2025-01-23","2025-01-23","2025-01-15","2024-12-06","2025-01-10","2025-06-27","2025-06-27","2025-06-27","2025-06-27","2023-06-20","2023-02-28","2024-07-27","2023-05-17","2025-11-06","2023-05-17","2025-10-28","2025-01-09","2024-11-06","2024-07-27","2024-07-27","2024-07-27","2025-06-16","2025-02-18","2025-02-18","2025-02-18","2024-12-09","2025-01-21","2025-10-27","2023-06-20","2023-06-07","2025-01-09","2023-11-27","2023-12-22","2023-11-27","2023-05-17","2023-05-17","2023-05-17","2023-05-17","2023-02-28","2023-02-28","2023-05-17","2024-06-07","2024-12-06","2023-06-28","2023-06-28","2025-02-03","2024-07-28","2024-12-10","2022-12-19","2022-12-19","2024-08-20","2025-06-27","2023-09-21"],"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":[["","","GABAPENTIN","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","PRAMIPEXOLE DIHYDROCHLORIDE","","","Select","Select",""],["","","DESCOVY","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","BUPROPION HCL SR","","","Select","Select",""],["","","CLONIDINE HCL","","","Select","Select",""],["","","IMIQUIMOD","","","Select","Select",""],["","","BETAMETHASONE DIPROPIONATE","","","Select","Select",""],["","","HYDROCORTISONE","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","BOOSTRIX TDAP","","","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":""}]}]}