{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Joseph C Chawes","gend":0,"currentgend":"","add":"48 MILL LN","city":"Westbrook","state":"ME","zip":"04092","dob":"1949-05-13","age":"","mstatus":"","insh":"10000033516","cliId":"","pno":"2079392528","cno":"","email":"joechawes@gmail.com","ename":"","eno":"","pphy":"WADLAND, WILLIAM R","ppno":"2078282402","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":"48 MILL LN","madd2":"","madd3":"","mcity":"Westbrook","mstate":"ME","mzip":"04092","pcpfaxno":"2078287850","pcpnpi":"1154499002","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4NH2W75VN25","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":["H401123","H401112","M79671","C880","H43821","H4423","H43813","H2511","H401113","H401122","Z23","Z0101","H401134","D649","E785","R6889","M109","N182","I10","F32A","R7989","D7589","R0600","M546","R21","J90","J984","R918","R590","C9100","C782","C778","C801","J948","R194","K640","R0781","J942","C8330","R222","C8510","D696","Z01818","C8800","G893","K2100","K449","K3189","Z79811","G453","I6523","C8338","D693","M25552","M549","S7002XA","N2889","Z452","Z5112","H35371","Z5111","I6340","Z9221","I6521","M79659","H539","C83398","D472","L821","D1801","Z85828","R791","G4700","C8801","G510","H26492","K2090","C419","M898X8","R4182","H409","R0602","J910","D485","H5213","R531","I959","C8332","H401131","R634","C8331","Z8579","R591","I3139","E041","Z515","E861"],"date":["2023-05-24","2023-05-24","2023-11-20","2024-08-13","2025-03-18","2025-03-18","2025-03-18","2025-10-22","2023-11-15","2023-11-15","2025-10-01","2023-12-05","2023-12-05","2024-07-25","2025-12-17","2023-12-05","2024-02-22","2025-09-26","2025-12-17","2024-04-05","2025-10-09","2024-03-28","2024-06-03","2024-06-03","2024-06-03","2026-02-16","2024-06-04","2025-11-20","2026-02-16","2024-06-21","2024-06-22","2024-06-22","2024-08-05","2024-06-21","2024-06-12","2024-06-12","2025-01-10","2024-06-21","2026-02-23","2026-03-03","2026-03-03","2026-02-16","2026-01-13","2026-02-26","2026-01-15","2025-12-17","2025-12-17","2025-12-17","2025-12-17","2025-04-01","2025-04-01","2026-02-16","2026-02-26","2026-02-16","2026-02-16","2026-02-16","2026-02-16","2025-01-15","2026-03-03","2025-09-18","2024-11-29","2026-02-24","2025-01-15","2026-02-23","2026-02-23","2026-02-23","2026-02-03","2026-01-24","2025-12-10","2025-12-10","2025-12-10","2026-01-22","2024-10-17","2026-01-29","2025-03-21","2025-09-09","2025-12-17","2025-12-01","2025-12-01","2024-07-15","2024-07-15","2024-08-07","2024-08-05","2025-12-10","2025-11-13","2024-08-07","2024-08-13","2025-12-13","2025-12-09","2024-08-07","2024-07-15","2024-07-15","2024-07-22","2024-07-24","2024-09-25","2024-08-09","2024-08-09"],"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":[["","","HYDROCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","GAVILYTE-G","","","Select","Select",""],["","","ATORVASTATIN","20 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","12.5 MG","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","WAYRILZ","","","Select","Select",""],["","","Dorzolamide\/Timolol Pf 2\/0.5 % Ophth Sol I","","","Select","Select",""],["","","ACYCLOVIR","400 MG","","Select","Select",""],["","","INDOMETHACIN","50 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","DEXAMETHASONE","4 MG","","Select","Select",""],["","","ALLOPURINOL","300 MG","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","236 GM","","Select","Select",""],["","","Sucralfate","1 GM","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","400\/80 MG","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","Amlodipine","5 MG","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","Famotidine","40 MG","","Select","Select",""],["","","Atovaquone","750 MG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","COLCHICINE","0.6 MG","","Select","Select",""],["","","Lidocaine 5 % Patch Endo","","","Select","Select",""],["","","TRAMADOL","50 MG","","Select","Select",""],["","","Dorzolamide\/Timolol 2\/0.5 % Ophth Sol Micr","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Somerset","","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol Sandoz","","","Select","Select",""],["","","Dorzolamide\/Timolol 2\/0.5 % Ophth Sol B&L","","","Select","Select",""],["","","Dorzolamide\/Timolol 2\/0.5 % Ophth Sol Some","","","Select","Select",""],["","","Lidocaine 5 % Patch Par","","","Select","Select",""],["","","LIDOCAINE","0.05","","Select","Select",""],["","","PEG","3350\/ELECTROLYTES 236","","Select","Select",""],["","","LATANOPROST","0.00005","","Select","Select",""],["","","DORZOLAMIDE\/TIMOLOL","2\/0.5 %","","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":""}]}]}