{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steven W Kemp","gend":0,"currentgend":"","add":"28 DANIELLE DR","city":"Topsham","state":"ME","zip":"04086","dob":"1947-04-04","age":"","mstatus":"","insh":"10000028698","cliId":"","pno":"2077514849","cno":"","email":"STEVENwKEMP@yahoo.com","ename":"","eno":"","pphy":"DECK, MARCUS M","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":"28 DANIELLE DR","madd2":"","madd3":"","mcity":"Topsham","mstate":"ME","mzip":"04086","pcpfaxno":"2077984018","pcpnpi":"1891717872","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5NP6P85EP61","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":["L739","D225","L814","L821","L578","D492","B351","M79674","M79675","B09","G4733","I6302","E6609","Z6834","N189","N1832","Z0101","E119","H2513","H524","H52223","H5211","R0602","R0981","R0600","E1151","I4891","Z23","R262","R531","R5381","I358","I77810","M6282","R079","S0990XA","J329","R9089","J341","Z0389","T796XXA","I10","H52222","H5202","L304","L98491","Z0000","E1122","N1831","E785","E876"],"date":["2023-04-04","2024-04-02","2024-04-02","2024-04-02","2024-04-02","2023-04-04","2025-12-16","2025-09-12","2025-09-12","2023-07-08","2023-09-30","2023-07-21","2023-07-21","2023-07-21","2023-08-24","2025-05-16","2024-12-09","2025-07-28","2024-12-09","2024-12-09","2023-09-15","2023-09-15","2023-09-30","2023-09-30","2023-09-30","2023-09-30","2023-10-13","2025-03-26","2025-12-16","2024-04-05","2024-04-05","2024-04-06","2024-04-06","2024-05-10","2024-04-05","2024-04-05","2024-04-05","2024-04-05","2024-04-05","2024-04-07","2024-04-05","2025-10-04","2024-12-09","2024-12-09","2025-02-14","2025-02-14","2025-10-04","2023-02-27","2023-02-27","2023-03-08","2023-03-08"],"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":[["","","NYSTOP","","","Select","Select",""],["","","FLUCONAZOLE","150 MG","","Select","Select",""],["","","ESCITALOPRAM","10 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Taro","","","Select","Select",""],["","","PRAVASTATIN","20 MG","","Select","Select",""],["","","Rybelsus (Formulation R1)","","","Select","Select",""],["","","POTASSIUM CL","20 MEQ","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","LOSARTAN","25 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Ascend Labs","","","Select","Select",""],["","","DICYCLOMINE","20 MG","","Select","Select",""],["","","DIAZEPAM","5 MG","","Select","Select",""],["","","TERBINAFINE","250 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","CLOTRIMAZOLE","10 MG","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Encube","","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","Clotrim\/Betameth Diprop 1\/0.05 % Cream Fou","","","Select","Select",""],["","","Clobetasol 0.05 % Cream Encube","","","Select","Select",""],["","","SPIRONOLACTONE","25 MG","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","CEFDINIR","300 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","Betamethasone Diprop 0.05 % Ointment Viona","","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","CLOTRIM\/BETAMETH DIPROP","1\/0.05 %","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","CLOBETASOL","0.0005","","Select","Select",""],["","","RYBELSUS (FORMULATION R","","","Select","Select",""],["","","BETAMETHASONE DIPROP","0.0005","","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":""}]}]}