{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard D Spicer","gend":0,"currentgend":"","add":"217 BUKER RD","city":"LITCHFIELD","state":"ME","zip":"04350","dob":"1945-12-29","age":"","mstatus":"","insh":"10000106980","cliId":"","pno":2072684153,"cno":"","email":"spydermaine@aol.com","ename":"","eno":"","pphy":"BEGGS, ALEX W","ppno":2077955700,"pcpadd":"12 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407676","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE INTERNAL MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"217 BUKER RD","madd2":"","madd3":"","mcity":"LITCHFIELD","mstate":"ME","mzip":"04350","pcpfaxno":2077955727,"pcpnpi":1750862769,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2EN4VG3HV94","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["F32A","E1100","I10","N189","G459","N201","G9341","R0989","N179","R600","N200","N1830","E1122","N1831","E119","M5441","K130","L814","Z08","Z85828","N132","R109","R52","Z87442","I69320","G9389","E039","I129","N202","N136","R4701","I679","N401","E785","R410","H6121","R2681","I639","N1330","N139","R1032","N12","M5450","R5381","Z8673","I69398","R319","R251","M47816","Z0000","H35371","H40003","R351","Z125","R809","R6889","R079"],"date":["2025-10-29","2025-02-10","2025-10-29","2024-11-15","2025-08-27","2023-06-22","2025-08-08","2025-08-08","2025-08-08","2025-08-08","2025-07-08","2025-08-08","2024-02-12","2024-05-07","2024-09-30","2024-09-30","2023-07-12","2023-07-12","2023-07-12","2023-07-12","2023-05-29","2023-05-29","2023-05-28","2025-06-13","2025-08-06","2025-08-07","2025-10-01","2025-08-06","2023-05-30","2023-05-30","2023-05-30","2025-08-27","2024-12-19","2025-08-27","2025-08-06","2024-06-04","2025-10-15","2025-09-29","2023-05-30","2023-05-30","2023-05-29","2023-05-30","2024-12-02","2025-08-08","2025-08-08","2025-08-08","2025-10-29","2025-10-29","2024-10-03","2023-05-11","2024-11-26","2024-11-26","2025-07-08","2025-07-08","2024-05-07","2023-08-04","2025-10-07"],"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":[["","","JANUVIA","","","Select","Select",""],["","","HYDRALAZINE HCL","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","COMIRNATY 2025-2026 (12Y UP)","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","FLUZONE HIGH-DOSE 2025-2026","","","Select","Select",""],["","","SYNTHROID","","","Select","Select",""],["","","FLUZONE HIGH-DOSE TRIV 2024-25","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","PREVNAR 20","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","BOOSTRIX TDAP","","","Select","Select",""],["","","CHLORHEXIDINE GLUCONATE","","","Select","Select",""],["","","CIPROFLOXACIN HCL","","","Select","Select",""],["","","SOLIFENACIN SUCCINATE","","","Select","Select",""],["","","IBU","","","Select","Select",""],["","","CEPHALEXIN","","","Select","Select",""],["","","TRIAMCINOLONE ACETONIDE","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD 2023-24","","","Select","Select",""],["","","IBUPROFEN","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}