{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Larry H Genthner","gend":0,"currentgend":"","add":"166 W HAMLET","city":"NEWCASTLE","state":"ME","zip":"04553","dob":"1954-10-25","age":"","mstatus":"","insh":"10000102003","cliId":"","pno":2073801993,"cno":"","email":"Declined@110323.com","ename":"","eno":"","pphy":"CLARK, MICHAEL E","ppno":2078615000,"pcpadd":"Maine Dartmouth Family Medicine,149 North St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"MAINE DARTMOUTH FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"166 W HAMLET","madd2":"","madd3":"","mcity":"NEWCASTLE","mstate":"ME","mzip":"04553","pcpfaxno":2078615101,"pcpnpi":1053387936,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4DV6UM2MP75","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z01812","I639","L2489","M25551","M170","I890","Z0100","R2241","Z471","E041","G8918","M1711","K219","I10","M1712","E669","L282","M25512","I6930","J310","I493","I4710","I4720","J3489","M25562","Z96652","M25462","M160","M19012","K2900","M7062","Z96653","J34829","J353","Z96659","M25569","A000","J343","Z0001","K2100","J309","G609","F419","I358","I491","R6889","M85861","Z0189","M85862","G629","M25561","Z96651","E785","L570","Z8673","R29898","R4781","R29818","M7121","J341","R600","R519","R202","R200","L259","Z1211","R0982","M25552","Z01818","J986","M2392","I6781","R4702","G63","R7989"],"date":["2025-03-11","2024-05-01","2023-06-09","2025-10-29","2025-03-11","2025-10-07","2025-07-08","2025-10-08","2025-10-23","2024-10-29","2025-05-06","2025-09-02","2025-05-06","2025-11-13","2025-04-23","2025-11-13","2023-08-29","2024-10-21","2024-04-19","2024-10-31","2024-02-08","2024-02-08","2024-02-08","2023-12-07","2025-04-10","2025-04-29","2025-04-10","2025-09-15","2025-09-15","2025-04-29","2025-04-29","2025-10-23","2024-10-31","2023-12-07","2025-04-12","2025-04-12","2025-05-08","2025-01-27","2023-03-03","2023-03-03","2023-05-15","2023-03-03","2024-10-31","2023-01-31","2023-01-31","2023-10-28","2025-03-11","2025-03-12","2025-03-11","2024-04-11","2025-05-20","2025-05-20","2025-09-12","2024-12-09","2024-03-22","2024-02-08","2024-02-08","2024-02-08","2025-10-08","2024-02-08","2025-10-31","2024-02-08","2024-02-08","2024-02-08","2023-05-15","2023-09-15","2023-09-15","2024-09-09","2025-03-12","2025-03-12","2023-01-17","2024-02-08","2024-02-08","2024-03-22","2024-04-15"],"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":[["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","IPRATROPIUM BROMIDE","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","SCOPOLAMINE","","","Select","Select",""],["","","LORAZEPAM","","","Select","Select",""],["","","FLUTICASONE PROPIONATE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","CLINDAMYCIN HCL","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","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":""}]}]}