{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Richard E Violette","gend":0,"currentgend":"","add":"90 EAST RD","city":"VAN BUREN","state":"ME","zip":"04785","dob":"1953-01-27","age":"","mstatus":"","insh":"10000111931","cliId":"","pno":2078653568,"cno":2076592662,"email":"declined@09062024.com","ename":"","eno":"","pphy":"DESROSIER, LINDSEY","ppno":2078682796,"pcpadd":"St John Valley Health Center,4 Main St","pcpcity":"Van Buren","pcpstate":"ME","pcpzip":"04785","pcpcounty":"","pcpid":"","pcpname":"PINES ST JOHN VALLEY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 76","madd2":"","madd3":"","mcity":"VAN BUREN","mstate":"ME","mzip":"04785","pcpfaxno":2078682799,"pcpnpi":1366051666,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4P21X70FR94","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["K5090","E1169","G4733","R002","Z0101","E113292","Z961","E119","H26493","E1136","R079","M25551","R6889","I498","I493","I25118","Z471","Z96641","Z7689","R0609","Z8701","Z5181","R918","R942","M8589","I517","K5010","Z1211","Z01818","R0989","K5000","M1611","M25552","Z96649","Z79620","Z7901","Z8719","R931","J101","I4819","I2510","I083","K50012","Z7985","I10","G4730","R0602","I4891","I480"],"date":["2025-07-02","2025-02-07","2025-09-13","2024-06-03","2025-01-16","2025-01-16","2025-04-21","2025-08-08","2025-04-21","2025-04-21","2025-02-02","2025-02-05","2024-10-21","2025-01-31","2025-05-14","2025-06-30","2025-08-28","2025-08-08","2025-05-28","2024-02-13","2024-02-13","2025-08-09","2024-02-09","2024-10-21","2024-02-09","2025-06-30","2024-02-01","2024-02-01","2025-07-25","2024-11-07","2024-01-25","2025-08-08","2025-02-05","2025-09-02","2024-11-12","2025-08-08","2024-11-12","2025-05-16","2025-02-13","2025-01-22","2025-04-03","2024-12-04","2024-06-08","2025-08-08","2025-08-08","2025-08-08","2025-02-13","2025-02-13","2025-03-03"],"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":[["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","ESCITALOPRAM OXALATE","","","Select","Select",""],["","","COMIRNATY 2024-2025","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","PRAVASTATIN SODIUM","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","DOFETILIDE","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","SPIKEVAX 2024-2025","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","ONETOUCH ULTRA TEST STRIP","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","STELARA","","","Select","Select",""],["","","OSELTAMIVIR PHOSPHATE","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE ER","","","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":{"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":""}]}]}