{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Jay Hanson Hoel","gend":1,"currentgend":"","add":"30 MELLEN ST UNIT 201","city":"Portland","state":"ME","zip":"04101","dob":"1972-07-07","age":52,"mstatus":"","insh":"10000103326","cliId":"","pno":2072192169,"cno":"","email":"DECLINED@09252025.COM","ename":"","eno":"","pphy":"ROVNER, ROBERT B","ppno":2076753121,"pcpadd":"Steep Falls Family Practice,PO Box 39","pcpcity":"Steep Falls","pcpstate":"ME","pcpzip":"04085","pcpcounty":"","pcpid":"","pcpname":"STEEP FALLS FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 1264","madd2":"","madd3":"","mcity":"Sanford","mstate":"ME","mzip":"04073","pcpfaxno":2076753396,"pcpnpi":1902912371,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8N63VJ8JA85","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":[],"comment":[],"score":[]}}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["T2122XA","F250","F3164","R140","D3502","E119","Z6842","F99","F312","F319","F209","Z743","F3110","Z8639","K582","E278","S52572A","Z5900","Z3202","F29","F4310","F419","F3130","E785","G629","G4733","R4182","F23","M549","F17210","S52572D","Z5902","Z91148","Z9102","R519","R410","S0990XA","S299XXA","S3991XA","S3993XA","S52502A","F4323","M79641","W19XXXA","M50322","M47812","M25532","F22","S52592A","S59902A","R4589","R9431","G4700","M79602","W101XXA","F603","R440","R45851","Z0389","F411","S6292XA","M7989","Z79899","Z008","F17290","M25522","Z0000","I83813","I83893","R531","E6601","R55","M4802","M4807","F3131","R12","S199XXA","R600","R1032","I83811","I83891","M79669","M5430","S53402A","R109","M2550","Z131","F600","F332","R630","R0602","K219","J4520","R5383","Z5181","R070","Z5189","Z7189","R748","M4722","M4312","M5416","E279","M5117","M4726","M4316","D3501","R262","Z6834","G894","I890","F418","G8929","Z113","R21","Z136","J45998","E348","R197","Z9884"],"date":["2025-09-15","2025-09-23","2025-01-06","2023-08-09","2023-08-09","2025-09-15","2025-09-15","2023-11-21","2024-05-13","2025-07-16","2024-12-23","2025-07-16","2023-11-14","2023-07-22","2023-07-22","2023-07-22","2025-10-14","2025-08-31","2023-08-09","2025-04-21","2023-09-01","2023-10-26","2023-10-26","2023-10-26","2023-10-26","2024-01-21","2025-10-11","2023-10-17","2023-10-17","2025-08-28","2025-10-01","2023-09-29","2023-09-29","2023-09-29","2023-09-10","2025-06-21","2023-10-17","2023-10-17","2023-10-17","2023-10-17","2025-09-28","2023-07-20","2025-10-14","2025-10-14","2023-09-10","2023-09-10","2025-10-01","2025-10-20","2025-10-01","2025-09-28","2025-10-13","2025-10-17","2023-08-24","2025-09-28","2025-09-28","2025-08-31","2025-07-16","2023-08-19","2023-08-24","2023-09-01","2025-09-28","2025-09-28","2025-06-21","2023-11-21","2025-06-30","2023-02-14","2025-08-07","2023-07-06","2023-07-06","2025-07-01","2023-10-24","2023-04-17","2023-04-17","2023-04-17","2023-07-07","2023-04-06","2023-01-17","2023-03-06","2023-01-17","2023-03-27","2023-03-27","2023-01-14","2023-01-14","2023-01-17","2023-01-17","2023-07-10","2023-01-16","2025-01-06","2024-12-23","2023-07-08","2025-06-20","2025-06-21","2025-06-21","2025-06-30","2025-05-23","2025-06-20","2023-02-21","2025-08-07","2023-03-20","2023-03-23","2023-03-23","2023-03-23","2023-03-12","2023-03-23","2023-03-23","2023-03-23","2023-06-21","2023-02-21","2023-10-24","2023-02-21","2023-01-16","2023-10-30","2023-10-30","2023-06-30","2023-06-19","2025-09-09","2024-10-30","2023-06-30","2023-07-08","2023-07-08"],"priorHcc":["","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","","",""]}},{"a":[]}]},{"t":"COVID Screening","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}}]},{"t":"Self-Assessment and Social History (SDOH)","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":[false,false,false],"comment":["","",""],"score":["","",""],"textValue":""}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":["","",""],"comment":["","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}}]},{"t":"Activities of Daily Living","q":[{"a":[["","",""],["","",""],["","",""],["","",""],["","",""],["","",""]]}]},{"t":"Medical History","q":[{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"index":-1,"comment":"","sub":[]},{"a":[{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]},{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}]},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","","","","","","","","","","","",""],"comment":["","","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","","",""],"comment":["","","","","","",""],"sub":[]}}]},{"t":"Family History","q":[{"index":-1,"comment":"","sub":[]}]},{"t":"Preventive Care","q":[{"a":[["","","",""],["","","N\/A",""],["","","N\/A",""],["","","",""],["","","N\/A",""],["","","N\/A",""],["","","N\/A",""],["","","N\/A",""],["","","N\/A",""],["","","N\/A",""],["","","N\/A",""],["","","",""],["","","N\/A",""],["","","N\/A",""],["","","N\/A",""],{"comment":""}]},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}}]},{"t":"Allergies \/ Medications","q":[{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"comment":"","sub":[["","","PERPHENAZINE","","","Select","Select",""],["","","TESTOSTERONE","","","Select","Select",""],["","","LITHIUM CARBONATE","","","Select","Select",""],["","","BUSPIRONE HCL","","","Select","Select",""],["","","LITHIUM CARBONATE ER","","","Select","Select",""],["","","METFORMIN HCL ER","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","OLANZAPINE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","SUMATRIPTAN SUCCINATE","","","Select","Select",""],["","","LAMOTRIGINE","","","Select","Select",""],["","","FLUCONAZOLE","","","Select","Select",""],["","","HYDROXYZINE HCL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","CLOTRIMAZOLE","","","Select","Select",""],["","","LURASIDONE HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","LATUDA","","","Select","Select",""],["","","OMEPRAZOLE","","","Select","Select",""],["","","TESTOSTERONE CYPIONATE","","","Select","Select",""],["","","MUPIROCIN","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","METHOCARBAMOL","","","Select","Select",""]]}},{"a":{"index":-1,"commentTxt":"","arr":[]}},{"a":{"indx":[],"comment":[],"sub":{"indx":["","","","","","","",""],"comment":[""],"sub":[],"textValue":""}}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":[false],"comment":[""],"score":[""]}}]},{"t":"Assessment of Diagnoses","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false,false],"comment":["","","","","","","","",""],"score":["","","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false,false],"comment":["","","","","","","",""],"score":["","","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":["","","",""],"comment":["","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["","",""],"comment":["","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}],"phq":[{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"indx":["","","",""],"comment":["","","",""],"sub":[]},{"subGroup":[{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","",""],"comment":["","","",""]},{"indx":["","","","","",""],"comment":["","","","","","",""]},{"indx":["","","","","",false],"comment":[""]}]}]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[{"indx":["",""],"comment":["",""],"sub":[]}]}},{"a":{"indx":[false,false,false,false,false,false],"comment":["","","","","",""],"score":["","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":{"indx":["",""],"comment":["",""],"sub":[{"indx":[],"comment":[],"sub":[]}],"subgroup":[]}},{"a":{"indx":[false,false,false,false,false,false,false],"comment":["","","","","","",""],"score":["","","","","","",""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Pain","q":[{"a":{"indx":["",""],"comment":["",""],"sub":[[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]]}}]},{"t":"Vital Signs","q":[{"a":["","","","","","",false,false]},{"a":["","","","",{"txt":""},{"malnutrition":{"indx":["","","","","","",""],"sub":{"indx":[],"comment":[],"sub":[]}}}]},{"a":{"indx":["","","","","","","","","","","",""],"comment":["","","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["","","","","",""],"comment":["","","","","",""],"sub":[]}},{"arr":[],"comment":[]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","",""],"comment":["","","","","","","","",""],"sub":[]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Exam Review","q":[{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":[""],"comment":[""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","",""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[[],[],[],[],[],[],[],[],[],[],[]],"comment":[["","","","",""],[""],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":[false,false,false],"comment":["","",""],"score":["","",""]}}]},{"t":"Mini-Cog","q":[{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":{"data":["","1","","","","0"],"indx":[false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false,false],"version":[false,false,false,false,false,false]}},{"a":{"indx":[false,false,false,false,false],"comment":["","","","",""],"score":["","","","",""]}}]},{"t":"Home Safety & Personal Goals","q":[{"a":{"indx":["","","","",""],"comment":["","","","",""],"score":[0,0,0,0]}},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"a":[]},{"a":{"indx":[false,false],"comment":["",""],"score":["",""]}},{"a":[{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]},{"indx":["",""],"comment":["",""],"sub":[]}]},{"a":{"indx":[false],"comment":[""],"score":[""]}},{"a":[""]},{"arr":[],"comment":[]},{"a":{"indx":["","","","","","","","","","",""],"comment":["","","","","","","","","","",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}},{"a":{"indx":["",""],"comment":["",""],"sub":[]}}]},{"t":"Active Problem Conditions","q":[{"a":[]}]},{"t":"Patient Summary","q":[{"a1":"","a2":"","a3":"","a4":"","a5":"","a6":"","a7":[],"a8":"","a9":"select","a10":[],"a11":"","a12":"","a13":"","a15":[],"a14":"","a16":"","a18":""}]}]}