{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gregory Toothaker","gend":0,"currentgend":"","add":"16 LEDGEVIEW DR","city":"SABATTUS","state":"ME","zip":"04280","dob":"1957-04-06","age":"","mstatus":"","insh":"10000111701","cliId":"","pno":2073758443,"cno":"","email":"","ename":"","eno":"","pphy":"THORP, LYDIA A","ppno":2075243501,"pcpadd":"180 CHURCH HILL RD STE 1,","pcpcity":"LEEDS","pcpstate":"ME","pcpzip":"42633418","pcpcounty":"","pcpid":"","pcpname":"DFD RUSSELL MEDICAL CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"16 LEDGEVIEW DR","madd2":"","madd3":"","mcity":"SABATTUS","mstate":"ME","mzip":"04280","pcpfaxno":2075242093,"pcpnpi":1801875018,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7RT4AQ7VV79","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S300XXA","G4733","I10","E11621","L97511","M7601","M25511","G8929","M7070","I161","I440","I252","I4510","M5412","R519","Z515","R030","R031","E859","R7989","E249","E785","M542","R6889","R1310","R55","D509","T17300A","R6330","S71002A","G243","I2510","I701","N401","E1140","M7981","S7002XD","L98492","L97519","R4182","S300XXD","Z4801","E119","Z794","H16223","M19011","M25411","M25711","E1169","S31809A","R269","J45909","S7002XA","S31829D","I674","G903","M47812","I25719","E782","M5021","M4312","X58XXXA","T8189XA","I639","I951","G4700","I6522","R351","R319","I6523","E1142","G909","E349","I5020","I358","I340","S7001XA","R42","I25810","I509","R258","S71002D","R21","Z7901","S79912A","M25562","I959","T8130XA","S0003XA","S0990XA","I5043","I63232","M48061","M47816","M7521","M7581","R5383"],"date":["2024-09-08","2024-12-01","2025-06-04","2024-03-20","2024-03-20","2024-09-05","2024-05-16","2024-08-05","2024-09-03","2024-12-18","2024-09-13","2025-01-29","2024-09-05","2024-07-16","2025-05-29","2025-06-03","2025-06-03","2025-06-03","2024-12-20","2024-11-26","2025-07-29","2024-12-19","2024-08-05","2025-05-08","2025-05-15","2025-07-02","2024-12-19","2024-09-06","2024-09-06","2025-07-22","2024-01-15","2024-10-02","2024-11-07","2024-10-30","2024-09-05","2024-09-05","2025-08-06","2025-07-30","2024-03-20","2025-05-29","2024-09-11","2024-10-11","2025-09-25","2024-01-11","2024-01-11","2024-05-06","2024-05-06","2024-05-06","2024-03-20","2024-12-27","2024-05-02","2024-04-29","2024-10-09","2025-08-27","2024-11-09","2025-01-29","2024-05-01","2025-01-29","2025-01-29","2024-05-01","2024-05-01","2024-09-05","2024-09-13","2025-06-04","2025-06-04","2025-06-04","2025-06-24","2024-10-30","2024-10-30","2025-05-29","2025-07-24","2025-05-29","2025-01-07","2025-05-30","2025-05-30","2025-05-30","2024-10-30","2024-06-03","2024-09-08","2024-09-08","2024-02-15","2025-08-13","2024-12-13","2024-07-01","2024-06-03","2024-06-03","2024-10-23","2024-12-13","2024-06-07","2024-06-03","2024-06-14","2024-11-04","2024-06-04","2024-06-04","2024-05-16","2024-05-16","2024-01-31"],"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":[["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","PANTOPRAZOLE SODIUM","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","FREESTYLE LIBRE 3 PLUS SENSOR","","","Select","Select",""],["","","DEXAMETHASONE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","SERTRALINE HCL","","","Select","Select",""],["","","OXYBUTYNIN CHLORIDE ER","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","FLUDROCORTISONE ACETATE","","","Select","Select",""],["","","PREGABALIN","","","Select","Select",""],["","","KETOCONAZOLE","","","Select","Select",""],["","","BACLOFEN","","","Select","Select",""],["","","EZETIMIBE","","","Select","Select",""],["","","MIDODRINE HCL","","","Select","Select",""],["","","HYDRALAZINE HCL","","","Select","Select",""],["","","FLUTICASONE-SALMETEROL","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","FINASTERIDE","","","Select","Select",""],["","","ONETOUCH ULTRA2","","","Select","Select",""],["","","CLONIDINE","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","FLUTICASONE-VILANTEROL","","","Select","Select",""],["","","ALBUTEROL SULFATE HFA","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ONETOUCH DELICA PLUS LANCET","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","PREDNISONE","","","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":{"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":{"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":""}]}]}