{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Thomas C Nannery","gend":0,"currentgend":"","add":"1435 ROYALSBOROUGH RD","city":"DURHAM","state":"ME","zip":"04222","dob":"1944-04-19","age":"","mstatus":"","insh":"10000012285","cliId":"","pno":"2076537238","cno":"2076537238","email":"tnannery8911@aol.com","ename":"","eno":"","pphy":"TRAPP, KATHLEEN R","ppno":"2077984400","pcpadd":"PO BOX 9746,","pcpcity":"PORTLAND","pcpstate":"ME","pcpzip":"41045040","pcpcounty":"","pcpid":"","pcpname":"MARTINS POINT HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"1435 ROYALSBOROUGH RD","madd2":"","madd3":"","mcity":"DURHAM","mstate":"ME","mzip":"04222","pcpfaxno":"2078287850","pcpnpi":"1386603397","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2G84KK4NF91","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":["I80209","I4891","J329","L84","I8003","R262","M79671","B351","M79675","M5450","I83899","D6862","I87323","I83891","M5412","M5030","M6281","M9901","Z7901","I87321","D649","E785","I10","M25552","R059","I083","I350","I480","Z0000","D531","M79674","L851","R053","M1612","I7389","Z981","Z91041","D729","S76012A","M87852","E538","R7989","I080","M7989","M7671","L03115","M7050","Z86718","Z87891","I8393","Z1211","K5090","M51369","M4726","M25551","K5790","N400","T148XXA","L03011","S60458A","M47816","M533","M79661","M48061","M79672","R2689","B070","H6012","I890","M1812","M5410","M7918","Q828","M5416","R2242","M19072","I83219","L97919","E7800","Z5189","M189","G609","K429","M25469","S81801D","M7041","M25561","S00411A","L602","R601","M1711","S81801A","M7022","S8292XA","Z9181","S81802A","S8392XA","L98492","M25562","M25462","M1712","I83893","M19042","F4320","Z79899","M109","M25532","K5010","R197","Z8719","I77810","I440","I4510","S6992XD","I5030","R0609","I82890","R5383","R0600","Z1159","J069","M79642","M85842","S60222A"],"date":["2023-06-19","2025-12-20","2023-05-16","2023-06-28","2024-09-03","2026-01-15","2025-10-15","2026-01-15","2023-06-28","2023-10-23","2023-07-27","2024-04-25","2023-10-05","2023-10-02","2023-10-23","2023-10-23","2023-10-23","2023-10-23","2026-02-18","2023-12-22","2024-12-02","2023-11-27","2026-01-19","2025-11-05","2024-09-30","2023-11-29","2025-11-26","2025-11-26","2025-12-17","2024-12-02","2024-09-03","2024-04-17","2024-04-26","2023-11-30","2024-04-17","2023-12-15","2023-12-15","2023-12-29","2023-12-27","2023-12-27","2024-04-03","2024-06-04","2024-06-10","2026-02-17","2024-07-01","2024-07-08","2024-07-02","2024-07-02","2024-07-02","2025-05-06","2025-10-22","2025-10-22","2026-01-22","2026-02-20","2026-02-20","2025-11-05","2025-11-05","2025-05-28","2024-11-02","2024-11-02","2026-01-22","2025-11-09","2026-01-19","2026-01-22","2025-12-15","2025-08-26","2025-10-15","2025-02-02","2025-05-21","2025-09-29","2025-11-05","2025-11-09","2025-08-26","2025-11-05","2025-12-17","2025-12-15","2025-03-12","2025-03-12","2025-12-05","2025-04-02","2024-09-30","2025-08-26","2025-11-26","2024-07-23","2024-07-23","2024-09-04","2024-07-29","2024-11-29","2025-01-28","2025-01-28","2024-08-08","2024-08-08","2024-09-04","2025-12-10","2025-12-17","2025-03-05","2025-12-10","2025-03-19","2025-12-10","2025-12-10","2025-12-10","2025-03-19","2025-05-20","2025-05-20","2025-12-05","2025-12-05","2025-07-15","2024-10-04","2025-10-06","2025-10-06","2023-03-15","2023-03-15","2023-03-15","2023-03-10","2023-02-07","2023-02-20","2023-02-10","2023-01-26","2023-01-26","2023-01-26","2023-01-24","2023-01-28","2023-01-28","2023-01-28"],"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":[["","","Mupirocin 2 % Ointment Teva","","","Select","Select",""],["","","WARFARIN","5 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","VALSARTAN\/HYDROCHLOROTHIAZIDE","320\/25 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","VALSARTAN","160 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","GABAPENTIN","100 MG","","Select","Select",""],["","","ACETAMINOPHEN\/CODEINE PHOS","300\/30 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","Silver Sulfadiazine 1 % Cream Ascend Labs","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","SILVER SULFADIAZINE","0.01","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","MUPIROCIN","0.02","","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":""}]}]}