{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Leroy W Kinney","gend":0,"currentgend":"","add":"31 ISINGGLASS RD","city":"Lyman","state":"ME","zip":"04002","dob":"1945-08-16","age":"","mstatus":"","insh":"10000033625","cliId":"","pno":"2074997332","cno":"","email":"dorisriche@gmail.com","ename":"","eno":"","pphy":"TOMPKINS, JODIE L","ppno":"2073583310","pcpadd":"Hello In There In Home Primary Care,62 Dawson St","pcpcity":"South Portland","pcpstate":"ME","pcpzip":"04106","pcpcounty":"","pcpid":"","pcpname":"HELLO IN THERE IN HOME PRIMARY CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"31 ISINGGLASS RD","madd2":"","madd3":"","mcity":"Lyman","mstate":"ME","mzip":"04002","pcpfaxno":"2073706045","pcpnpi":"1548372923","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8V07EJ2CA49","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","I10","L210","M6530","Z0101","B351","M79675","M79674","M65332","M65331","I480","Z7901","E785","L989","C44629","R233","Z85828","K5900","I4891","J069","I4820","E1159","L851","L821","L219","R053","E782","I110","Z1211","Z860101","Z538","K219","D124","D127","D126","K635","I5043","U071","R350","U099","J90","J439","D125","R0609","H2513","I5033","R0602","J9601","I509","H2512","L820","H2511","I083","I5020","J189","I081","J449","I5032","J849","E11649","R918","Z87891","R760","J432","R591","E1142","I4819","L600"],"date":["2026-03-09","2026-03-09","2023-05-18","2023-05-18","2025-08-05","2026-01-06","2023-09-20","2023-09-20","2023-06-06","2023-06-06","2025-02-13","2025-01-10","2025-02-04","2023-08-10","2023-08-17","2023-08-17","2025-12-04","2026-03-09","2026-02-05","2023-11-28","2025-11-11","2026-01-06","2026-01-06","2025-12-04","2025-12-04","2024-02-22","2024-05-28","2025-04-20","2026-02-06","2026-02-06","2026-02-05","2026-02-06","2026-02-06","2026-02-06","2026-02-06","2026-02-06","2025-01-22","2025-01-06","2026-03-09","2025-01-22","2025-01-22","2025-04-21","2026-02-06","2025-04-21","2025-10-30","2025-07-11","2025-04-20","2025-05-08","2024-12-12","2025-11-24","2025-12-04","2025-11-12","2025-04-21","2025-04-21","2025-04-20","2025-11-11","2025-04-18","2025-04-29","2025-06-15","2025-05-20","2025-10-20","2025-10-20","2025-07-29","2025-06-15","2025-06-15","2023-03-13","2023-03-13","2023-01-25"],"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":[["","","JARDIANCE","","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","TRUE METRIX","","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Pacific","","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","ROSUVASTATIN","40 MG","","Select","Select",""],["","","Clobetasol 0.05 % Top Sol Fougera","","","Select","Select",""],["","","CYCLOBENZAPRINE","5 MG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","AMLODIPINE","10 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","Ketorolac 0.5 % Ophth Sol Sandoz","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","Hydrocortisone 2.5 % Cream Perrigo","","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","TRUEPLUS ULTRA THIN","","","Select","Select",""],["","","ONETOUCH VERIO","","","Select","Select",""],["","","BEYFORTUS","","","Select","Select",""],["","","TIOTROPIUM","18 MCG","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","LAGEVRIO","","","Select","Select",""],["","","AMOXICILLIN\/CLAV","500\/125 MG","","Select","Select",""],["","","WIXELA INHUB","","","Select","Select",""],["","","Hydrocortisone 2.5 % Cream Fougera","","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","SPIRIVA HANDIHALER","","","Select","Select",""],["","","Ketoconazole 2 % Shampoo Padagis","","","Select","Select",""],["","","Metformin 1","","","Select","Select",""],["","","Nystatin 100","","","Select","Select",""],["","","CLOBETASOL","0.0005","","Select","Select",""],["","","HYDROCORTISONE","0.025","","Select","Select",""],["","","KETOROLAC","0.005","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","PEG","3350\/ELECTROLYTES 420","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","Select","Select",""],["","","METFORMIN","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","KETOCONAZOLE","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":""}]}]}