{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James M Cawood","gend":0,"currentgend":"","add":"207 SENATOR BLACK RD","city":"WEST BALDWIN","state":"ME","zip":"04091","dob":"1958-03-18","age":"","mstatus":"","insh":"10000105821","cliId":"","pno":2072867243,"cno":"","email":"Sampler3@hotmail.com","ename":"","eno":"","pphy":"STOCKWELL, GEORGE W","ppno":2078930290,"pcpadd":"144 STATE ST,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41013776","pcpcounty":"","pcpid":"","pcpname":"NORTHERN LIGHT MERCY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"207 SENATOR BLACK RD","madd2":"","madd3":"","mcity":"WEST BALDWIN","mstate":"ME","mzip":"04091","pcpfaxno":2078930295,"pcpnpi":1548293772,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4A87KE6QY65","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":["Z95810","G4733","S42221D","I480","I2510","Z0000","R6889","F1090","I10","N179","R780","S0990XA","R739","Z0100","I214","I2584","I4720","E785","G4730","R4182","R079","I4891","I358","I6523","Z950","I4729","I255","H6121","R0602","R296","F10929","R944","Z0101","E7800","R9430","S42301A","R600","S42221A","M25562","R21","H353131","S42341A","L739","W010XXA","Z136","M1712","H18232","I110","I5032","Z6841"],"date":["2025-10-02","2025-08-15","2024-04-17","2025-04-08","2025-07-07","2024-11-08","2023-06-05","2025-11-15","2025-11-15","2025-11-14","2025-02-04","2025-02-04","2023-12-01","2024-08-19","2024-08-15","2024-08-15","2024-08-15","2024-08-13","2024-08-13","2024-08-13","2024-08-09","2024-08-30","2024-08-10","2024-08-11","2024-08-13","2024-08-13","2024-08-13","2025-04-10","2025-02-04","2025-02-04","2025-02-04","2025-01-24","2025-11-03","2024-12-26","2024-09-20","2023-11-27","2023-09-05","2023-12-07","2023-09-05","2025-04-02","2023-06-05","2023-11-27","2025-06-02","2023-11-27","2025-04-08","2023-09-05","2025-04-21","2025-04-08","2025-04-08","2023-12-04"],"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":[["","","TORSEMIDE","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","POTASSIUM CHLORIDE","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","VALACYCLOVIR","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","TOBRAMYCIN-DEXAMETHASONE","","","Select","Select",""],["","","MOXIFLOXACIN","","","Select","Select",""],["","","BETAMETHASONE VALERATE","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","SPIKEVAX 2025-2026 (12Y UP)","","","Select","Select",""],["","","FLUAD 2025-2026","","","Select","Select",""],["","","FUROSEMIDE","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","OLMESARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","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":""}]}]}