{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard L Stockwood","gend":0,"currentgend":"","add":"20 BAYBERRY DR","city":"ELIOT","state":"ME","zip":"03903","dob":"1958-04-02","age":"","mstatus":"","insh":"10000106495","cliId":"","pno":7819537798,"cno":"","email":"","ename":"","eno":"","pphy":"BRADEN, TREVOR","ppno":2074394430,"pcpadd":"KITTERY FAMILY PRACTICE,35 WALKER ST","pcpcity":"KITTERY","pcpstate":"ME","pcpzip":"03904","pcpcounty":"","pcpid":"","pcpname":"KITTERY FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"20 BAYBERRY DR","madd2":"","madd3":"","mcity":"ELIOT","mstate":"ME","mzip":"03903","pcpfaxno":2074390968,"pcpnpi":1588739866,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4N07MW8RD51","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E1065","J189","E119","J208","M542","M5450","F3481","F411","F341","F900","Z0000","L570","Z1211","Z23","L03316","G4730","M25511","Z471","Z96611"],"date":["2025-09-04","2024-11-30","2025-10-08","2024-11-25","2024-08-06","2024-08-06","2025-09-18","2025-09-18","2025-09-18","2025-09-18","2025-03-18","2025-03-18","2024-01-07","2024-12-12","2024-04-02","2024-02-24","2023-05-30","2023-05-30","2023-05-30"],"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":[["","","DEXTROAMPHETAMINE-AMPHETAMINE","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","CITALOPRAM HBR","","","Select","Select",""],["","","NOVOLOG","","","Select","Select",""],["","","DEXTROAMPHETAMINE-AMPHET ER","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","METHYLPHENIDATE HCL CD","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","LANTUS","","","Select","Select",""],["","","METHYLPHENIDATE HCL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","FLUAD TRIVALENT 2024-2025","","","Select","Select",""],["","","DEXCOM G7 SENSOR","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","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":{"indx":[["","","",""],[],[""],[""],[],[""],[""]],"comment":[["","","",""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":{"indx":[["","","",""],[],[""],[""],[""],[""],[""],[""]],"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":""}]}]}