{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Christopher W Lane","gend":0,"currentgend":"","add":"19 WING ST","city":"LISBON FALLS","state":"ME","zip":"04252","dob":"1961-12-07","age":"","mstatus":"","insh":"10000047622","cliId":"","pno":"2074404890","cno":"","email":"opt-out@optout.com","ename":"","eno":"","pphy":"LIEGNER, ADAM","ppno":"2075826608","pcpadd":"4 HORTON PL,SUITE 101","pcpcity":"TOPSHAM","pcpstate":"ME","pcpzip":"40861747","pcpcounty":"","pcpid":"","pcpname":"GARDINER FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"19 WING ST","madd2":"","madd3":"","mcity":"LISBON FALLS","mstate":"ME","mzip":"04252","pcpfaxno":"2075822258","pcpnpi":"1265793574","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2J11E96KM10","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25552","M1612","E119","I10","R413","N179","M5416","N1831","E1140","D492","E1121","E1165","I129","R9341","E875","Z96643","M25551","G8929","Z471","Z96641","G5601","R200","R202","M5450","E1122","E1142","Z791","M5441","M5412","D649","D539","Z7984","M4724","M48061","M5116","M4727","R4182","Z4800","S91332A","M2550","E11621","L97422","R7989","D509","Z85828","L97522","M542","S91342A","Z794","Z1211","Z538","R29898","Z96642","M47816","S91302A","X58XXXA","M47812","M4802","M4312","S90922S","D631","M87059","Z0000","G6289","R531","R410","C44219","I517","H25813","Z483","M5117","M5114","Z4889","L02416","R0602","D122","K6389","K648","L989","L97421","C44212","B351","M1611","R419"],"date":["2024-03-15","2023-05-11","2025-10-31","2025-09-29","2023-05-08","2023-06-08","2025-05-13","2026-02-17","2026-02-25","2023-04-11","2023-04-11","2025-03-27","2026-02-17","2023-07-14","2023-09-14","2024-03-15","2024-03-15","2025-10-29","2023-11-10","2023-11-10","2023-11-08","2025-02-24","2024-02-27","2025-10-29","2026-02-17","2026-02-03","2026-01-28","2024-06-10","2025-04-01","2024-06-19","2024-03-19","2024-03-28","2024-06-10","2025-04-02","2025-04-02","2025-04-02","2025-07-31","2025-09-16","2025-07-14","2024-09-27","2025-09-16","2025-09-02","2025-12-17","2025-12-17","2025-12-17","2025-09-09","2025-01-11","2025-06-09","2025-09-29","2025-05-08","2025-01-22","2025-02-13","2023-03-22","2025-03-18","2025-07-14","2025-07-14","2025-02-24","2025-04-01","2025-02-24","2025-07-22","2026-02-17","2026-01-28","2025-10-03","2025-05-20","2025-07-31","2025-07-31","2025-02-20","2025-07-31","2024-12-02","2025-02-20","2025-04-02","2025-04-02","2025-10-29","2025-07-14","2025-07-31","2025-05-08","2025-05-08","2025-05-08","2024-11-12","2025-09-16","2024-12-19","2026-02-25","2023-02-22","2023-02-03"],"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",""],["","","Ge100","","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","LORAZEPAM","1 MG","","Select","Select",""],["","","AMITRIPTYLINE","50 MG","","Select","Select",""],["","","Embecta Nano 2Nd Gen (Ref 320550)","","","Select","Select",""],["","","PREGABALIN","225 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","ATORVASTATIN","40 MG","","Select","Select",""],["","","BISOPROLOL\/HYDROCHLOROTHIAZIDE","10\/6.25 MG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","DEXAMETHASONE","1 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","DULOXETINE","60 MG","","Select","Select",""],["","","ONETOUCH VERIO","","","Select","Select",""],["","","AMITRIPTYLINE HCL","","","Select","Select",""],["","","CIPROFLOXACIN","500 MG","","Select","Select",""],["","","Nano (Ref 320122)","","","Select","Select",""],["","","TOUJEO MAX SOLOSTAR","","","Select","Select",""],["","","MELOXICAM","7.5 MG","","Select","Select",""],["","","Ge100 Blood Glucose System","","","Select","Select",""],["","","CYCLOBENZAPRINE","10 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","ONETOUCH VERIO FLEX SYSTEM","","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","CAREONE UNIFINE PENTIPS PLUS","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","Dexcom G7 Receiver (Ref Stk-At-012)","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","TOUJEO SOLOSTAR","","","Select","Select",""],["","","UNILET MICRO-THIN","","","Select","Select",""],["","","ORPHENADRINE","100 MG","","Select","Select",""],["","","ACCU-CHEK SOFTCLIX","","","Select","Select",""],["","","Metformin 1","","","Select","Select",""],["","","DEXCOM G","7 RECEIVER","","Select","Select",""],["","","GE","100 BLOOD","","Select","Select",""],["","","METFORMIN","","","Select","Select",""],["","","PEG","3350\/ELECTROLYTES 420","","Select","Select",""],["","","BD NANO","","","Select","Select",""],["","","EMBECTA NANO","2ND GEN","","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":""}]}]}