{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard L Lacadie","gend":0,"currentgend":"","add":"28 PLEASANT ST","city":"MILFORD","state":"ME","zip":"04461","dob":"1950-11-20","age":"","mstatus":"","insh":"10000104433","cliId":"","pno":2079441865,"cno":"","email":"declined@090325.com","ename":"","eno":"","pphy":"ROBERTS, CHARLES A","ppno":2078276128,"pcpadd":"PO Box 1599,","pcpcity":"Bangor","pcpstate":"ME","pcpzip":"04402","pcpcounty":"","pcpid":"","pcpname":"HELEN HUNT HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 495","madd2":"","madd3":"","mcity":"MILFORD","mstate":"ME","mzip":"04461","pcpfaxno":2078276605,"pcpnpi":1295884716,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3A73N63XQ60","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":["N401","R339","E039","D649","E7800","R7309","D509","N400","M8589","J45901","I10","R197","M25551","M160","L299","M353","Z87898","Z87891","R338","Z79899","Z86010","K6389","D126","K5730","K648","M85851","Z1211","D122","K635","K2900","M159","M10079","H5203","H52223","H524","H2513","R9720"],"date":["2025-01-21","2023-01-06","2025-08-21","2023-06-23","2025-08-21","2025-09-04","2025-08-21","2025-01-07","2025-01-10","2024-04-29","2025-08-21","2023-04-11","2025-01-27","2025-01-27","2023-04-10","2025-03-19","2024-01-04","2025-01-21","2025-01-21","2025-01-21","2024-06-24","2024-06-24","2024-06-24","2024-06-24","2024-06-24","2024-02-13","2024-06-24","2024-06-24","2024-06-24","2024-07-01","2023-06-16","2023-06-16","2025-08-26","2025-08-26","2025-08-26","2025-08-26","2023-07-11"],"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":[["","","PREDNISONE","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","DULOXETINE HCL","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","MONTELUKAST SODIUM","","","Select","Select",""],["","","NAPROXEN","","","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":""}]}]}