{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Ronald Wright","gend":0,"currentgend":"","add":"1 HAWTHORN DR","city":"NORWAY","state":"ME","zip":"04268","dob":"1957-10-07","age":"","mstatus":"","insh":"10000120334","cliId":"","pno":2075151816,"cno":"","email":"forgiven1823@yahoo.com","ename":"","eno":"","pphy":"JOHANNESSON, INGA S","ppno":2077437721,"pcpadd":"8 PIKES HL,","pcpcity":"NORWAY","pcpstate":"ME","pcpzip":"42685340","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE FAMILY AND INTERNAL MEDIC","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1 HAWTHORN DR","madd2":"","madd3":"","mcity":"NORWAY","mstate":"ME","mzip":"04268","pcpfaxno":2077436306,"pcpnpi":1205863156,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7H72E47RY25","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z952","G4733","R911","G8929","Z0000","I330","T826XXA","E1140","Z23","M5417","E1142","E1165","Z794","Z79899","D71","R918","J984","I2510","E662","Z515","F331","N1831","E1122","I358","Z95818"],"date":["2025-11-10","2025-11-16","2025-02-27","2025-04-10","2025-03-28","2025-10-30","2025-10-30","2025-11-19","2025-11-19","2025-09-19","2025-06-20","2025-06-20","2025-06-20","2025-05-08","2025-02-27","2025-02-27","2025-02-27","2025-02-27","2025-07-28","2025-10-23","2025-01-27","2025-07-21","2025-03-18","2025-04-10","2025-10-02"],"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":[["","","WARFARIN SODIUM","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","GABAPENTIN","","","Select","Select",""],["","","ROPINIROLE HCL","","","Select","Select",""],["","","LANTUS SOLOSTAR","","","Select","Select",""],["","","TORSEMIDE","","","Select","Select",""],["","","FREESTYLE LIBRE 3 SENSOR","","","Select","Select",""],["","","VENLAFAXINE HCL ER","","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","HYDROMORPHONE HCL","","","Select","Select",""],["","","BUPRENORPHINE","","","Select","Select",""],["","","GLIPIZIDE ER","","","Select","Select",""],["","","TRAZODONE HCL","","","Select","Select",""],["","","TIZANIDINE HCL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","ULTRA-FINE PEN NEEDLE","","","Select","Select",""],["","","ULTRA-FINE MICRO PEN NEEDLE","","","Select","Select",""],["","","BUPRENORPHINE-NALOXONE","","","Select","Select",""],["","","NANO 2ND GEN PEN NEEDLE","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","BELBUCA","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","AMOXICILLIN","","","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":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"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":""}]}]}