{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ronald L Jones","gend":0,"currentgend":"","add":"25 STERLING DR","city":"WESTBROOK","state":"ME","zip":"04092","dob":"1948-12-02","age":"","mstatus":"","insh":"10000114183","cliId":"","pno":2076506499,"cno":"","email":"ronj.ccema@gmail.com","ename":"","eno":"","pphy":"FAY SHIELDS, JACOB A","ppno":2078392559,"pcpadd":"Martins Point Health Care,575 Main St","pcpcity":"Gorham","pcpstate":"ME","pcpzip":"04038","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"25 STERLING DR","madd2":"","madd3":"","mcity":"WESTBROOK","mstate":"ME","mzip":"04092","pcpfaxno":2075231135,"pcpnpi":1467038042,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6JN9QU2QW16","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":["J929","R590","Z5189","S199XXA","I480","C8510","Z98890","S0990XA","Z01818","I4892","I880","I2510","M9900","M9901","M9902","M9903","M9931","G6289","M25512","G8929","H8110","M5412","M60812","M9907","M65812","C8203","R55","D649","C8283","I4891","M75102","R7301","R9720","E785","M19012","C8290","S72002A","R4182","D509","M75112","S43432A","M7552","C8590","H04123","H43811","Z7901","S72045D","Z4789","I340","N401","H903","M75122","K4090","Z9189","M47812","S72045A","E119","M1632","S72042D","G8918","M25552","M1612","K4020","R609","M2540","R978","Z5112","Z471","Z96653","K148","Z974","M4606","M75101","Z719"],"date":["2025-06-27","2025-06-27","2024-10-01","2025-03-19","2025-11-07","2025-03-14","2025-11-11","2025-03-19","2025-08-28","2025-11-07","2025-10-07","2025-11-07","2025-08-18","2025-08-18","2025-08-18","2025-08-18","2024-09-18","2025-02-25","2025-08-18","2025-02-25","2025-03-27","2025-01-16","2024-08-05","2024-08-05","2024-08-05","2025-10-07","2025-03-19","2024-07-08","2025-03-14","2024-12-27","2024-11-19","2024-12-27","2025-10-07","2025-11-07","2025-09-19","2025-03-14","2024-12-03","2024-12-03","2024-12-03","2025-09-19","2025-09-19","2025-09-19","2025-10-06","2025-09-12","2025-09-12","2024-12-03","2025-04-09","2025-10-02","2025-02-10","2025-10-02","2025-09-17","2025-09-19","2025-01-28","2025-09-19","2024-08-15","2024-12-03","2024-02-13","2025-04-09","2024-12-18","2025-09-19","2025-07-14","2024-12-02","2024-12-02","2024-12-02","2024-12-02","2025-02-28","2025-08-05","2024-04-12","2024-04-12","2024-10-17","2024-10-17","2024-03-06","2025-09-05","2025-09-05"],"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":[["","","XARELTO","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","MECLIZINE HCL","","","Select","Select",""],["","","OXYCODONE HCL","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","CYCLOBENZAPRINE HCL","","","Select","Select",""],["","","AMOXICILLIN","","","Select","Select",""],["","","POLYMYXIN B SUL-TRIMETHOPRIM","","","Select","Select",""],["","","KETOROLAC TROMETHAMINE","","","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":[]}},{"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":""}]}]}