{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Peter A Landrigan","gend":0,"currentgend":"","add":"11 ROUNDABOUT LN","city":"Cape Elizabeth","state":"ME","zip":"04107","dob":"1944-10-19","age":"","mstatus":"","insh":"10000008659","cliId":"","pno":"2077674390","cno":"2077764632","email":"PLANDRIG@MAINE.RR.COM","ename":"","eno":"","pphy":"NORMAN, ANASTASIA R","ppno":"","pcpadd":"96 OCEAN ST STE 4,","pcpcity":"SOUTH PORTLAND","pcpstate":"ME","pcpzip":"41062855","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"2077674390","add2":"","add3":"","madd1":"11 ROUNDABOUT LN","madd2":"","madd3":"","mcity":"Cape Elizabeth","mstate":"ME","mzip":"04107","pcpfaxno":"","pcpnpi":"1073833703","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4DM5P84MK76","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":["R6889","H61002","L570","L821","D485","Z4889","R918","C8311","Z85820","L989","Z9484","M720","M25642","M79642","M6281","Z20822","R051","J069","Z23","L910","D492","C44519","D0359","D225","R399","N401","Z0101","L814","H2511","Z961","E782","Z131","R350","R339","C4359","H903","U071","C8310","R9402","D0471","D0439","D034","D224","H26491","J00","L905","C44319","C434","J0190","R0982","Z96652","M25562"],"date":["2023-04-18","2023-12-14","2025-12-09","2024-05-14","2023-12-14","2023-06-05","2024-06-10","2025-12-17","2025-06-24","2025-06-18","2025-06-18","2023-07-03","2023-07-03","2023-07-03","2023-07-03","2023-07-22","2023-07-22","2024-12-28","2024-05-21","2025-06-24","2025-12-09","2025-05-20","2023-11-06","2025-05-20","2024-12-09","2025-09-25","2025-12-11","2025-08-14","2024-07-15","2024-05-01","2025-06-02","2024-05-16","2025-11-19","2024-12-09","2025-05-20","2025-09-10","2025-12-09","2025-07-14","2025-07-13","2025-01-16","2025-01-16","2025-12-17","2025-12-17","2025-05-23","2024-10-13","2025-06-24","2025-12-17","2025-12-09","2025-01-03","2025-06-16","2025-05-02","2025-05-02"],"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":[["","","FLUAD","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","Doxazosin","4 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","FINASTERIDE","5 MG","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray B&L","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","PREVNAR","","","Select","Select",""],["","","IPRATROPIUM","0.0006","","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":""}]}]}