{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Lawrence I Grant","gend":0,"currentgend":"","add":"403 TOPAZ DR","city":"South Portland","state":"ME","zip":"04106","dob":"1951-08-05","age":"","mstatus":"","insh":"10000049998","cliId":"","pno":"2076151108","cno":"","email":"LGRANT1@MAINE.RR.COM","ename":"","eno":"","pphy":"CHAPPELLE, CATHRA M","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":"403 TOPAZ DR","madd2":"","madd3":"","mcity":"South Portland","mstate":"ME","mzip":"04106","pcpfaxno":"2078282425","pcpnpi":"1912957069","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8WY6TD5NP79","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":["G4731","Z7901","M1712","Z23","E119","L821","L820","L538","L298","D485","D2261","L814","Z7189","L570","R053","Z1211","D122","D125","K5730","G4733","R059","G4737","I4819","R0609","Z125","E785","I25118","I5030","I4820","M5450","R9720","L448","Z0101","H26491","I25119","H43811","D229","J449","J45901","J310","G20C","E1169","R339","I4811","I2510","I10","E7800","E1122","I129","N189","R0600","Z122","T24101A","Z87891","R062","R0602","F3181","E0590","I110","G4719"],"date":["2025-12-05","2026-02-20","2023-06-16","2025-10-08","2023-09-08","2024-06-11","2023-06-07","2024-01-18","2024-01-18","2024-01-18","2023-06-07","2024-06-11","2024-06-11","2024-06-11","2023-07-03","2023-06-27","2023-06-27","2023-06-27","2023-06-27","2025-12-26","2023-07-03","2024-11-22","2023-07-13","2025-10-10","2024-09-25","2025-10-03","2023-09-26","2025-11-26","2026-01-23","2023-10-05","2023-12-13","2024-01-18","2025-03-27","2024-03-20","2024-04-25","2025-03-27","2024-06-11","2025-12-26","2024-08-21","2025-12-26","2026-01-20","2026-01-20","2025-11-25","2025-03-05","2025-04-08","2026-01-20","2025-03-05","2024-08-21","2024-08-21","2024-08-21","2025-12-26","2026-01-15","2025-05-18","2026-01-15","2024-07-23","2026-03-10","2026-01-20","2025-10-03","2025-11-26","2023-03-17"],"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":[["","","ATENOLOL","100 MG","","Select","Select",""],["","","ESCITALOPRAM","20 MG","","Select","Select",""],["","","JANTOVEN","","","Select","Select",""],["","","WARFARIN","5 MG","","Select","Select",""],["","","Bd Nano 2 Gen","","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","ARIPIPRAZOLE","10 MG","","Select","Select",""],["","","ISOSORBIDE MONONITRATE","30 MG","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","ATORVASTATIN","40 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","LOSARTAN","100 MG","","Select","Select",""],["","","ACYCLOVIR","200 MG","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","ONETOUCH ULTRA BLUE","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Advagen","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Amneal","","","Select","Select",""],["","","AMLODIPINE","2.5 MG","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","SPIRIVA RESPIMAT","","","Select","Select",""],["","","PIOGLITAZONE","30 MG","","Select","Select",""],["","","OXYBUTYNIN","5 MG","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","INCRUSE ELLIPTA","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","ANORO ELLIPTA","","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","BUDESONIDE\/FORMOTEROL","160\/4.5 MCG","","Select","Select",""],["","","ALBUTEROL\/IPRATROPIUM","3\/0.5 MG\/3","","Select","Select",""],["","","PROPRANOLOL","80 MG","","Select","Select",""],["","","FINASTERIDE","5 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","CIPROFLOXACIN","500 MG","","Select","Select",""],["","","Onetouch Ultra 2","","","Select","Select",""],["","","ONETOUCH ULTRASOFT","","","Select","Select",""],["","","ONETOUCH ULTRA","","","Select","Select",""],["","","Dexcom G6 Transmitter","","","Select","Select",""],["","","Dexcom G6 Sensor","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","100 MG","","Select","Select",""],["","","DEXCOM G","","","Select","Select",""],["","","IPRATROPIUM","0.0006","","Select","Select",""],["","","BD NANO","","","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":""}]}]}