{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Stanley C Tanner","gend":0,"currentgend":"","add":"24 PARSONS WAY","city":"POLAND","state":"ME","zip":"04274","dob":"1941-09-11","age":"","mstatus":"","insh":"10000051428","cliId":"","pno":"2079985654","cno":"","email":"stanosl@aol.com","ename":"","eno":"","pphy":"BEGGS, ALEX W","ppno":"2077955700","pcpadd":"12 HIGH ST,","pcpcity":"LEWISTON","pcpstate":"ME","pcpzip":"42407676","pcpcounty":"","pcpid":"","pcpname":"CENTRAL MAINE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"24 PARSONS WAY","madd2":"","madd3":"","mcity":"POLAND","mstate":"ME","mzip":"04274","pcpfaxno":"2077955727","pcpnpi":"1750862769","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7AH3TC4YR60","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":["Z136","I10","R9720","N289","E7800","L570","X32XXXA","L821","L814","G4733","Z950","Z7689","D649","I442","I509","L600","L602","R6889","H40013","C44219","I7121","R051","F329","H938X9","K819","I080","K810","J449","K219","H6692","H6993","H6121","R0981","H109","H6120","J309","H6590","H6523","H6592","R42","R0602","Z0000","K589","N189","H903","Z974","Z570","R0609","L97511","K82A1","Z5331","R109","R079","K812","H906","Z5189","U071"],"date":["2023-04-28","2026-01-28","2023-05-24","2023-05-02","2023-05-02","2025-10-01","2025-10-01","2025-10-01","2025-10-01","2026-02-21","2026-02-11","2023-10-04","2026-01-28","2025-08-07","2025-05-07","2023-11-28","2023-11-28","2023-12-11","2025-01-24","2024-03-26","2024-06-14","2024-06-27","2026-02-21","2024-11-15","2026-01-06","2024-09-25","2025-12-31","2025-12-31","2025-12-31","2025-08-18","2025-12-15","2025-07-23","2025-07-17","2025-09-16","2025-07-09","2025-01-09","2024-12-02","2025-09-02","2025-07-17","2025-05-07","2025-10-19","2025-09-22","2024-10-02","2026-01-28","2025-09-02","2025-09-02","2025-09-02","2024-08-13","2025-09-16","2025-12-31","2025-12-31","2025-12-30","2025-12-30","2025-12-31","2025-12-15","2026-01-09","2023-02-17"],"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":[["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","FLUTICASONE PROP","50 MCG","","Select","Select",""],["","","TERAZOSIN HCL","","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","FAMOTIDINE","40 MG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Advagen","","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Amneal","","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","DICYCLOMINE","20 MG","","Select","Select",""],["","","BUPROPION HCL","150 MG","","Select","Select",""],["","","SIMVASTATIN","10 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","TERAZOSIN","5 MG","","Select","Select",""],["","","Erythromycin 0.5 % Ophth Oint B&L","","","Select","Select",""],["","","Ipratropium 0.06 % Nas Spray Apotex","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","IBUPROFEN","400 MG","","Select","Select",""],["","","COLESTIPOL","1 GM","","Select","Select",""],["","","Comirnaty 2023-2024","","","Select","Select",""],["","","METHYLPREDNISOLONE","4 MG","","Select","Select",""],["","","Neo\/Polymyx\/Hydrocortisone 3.5\/10","","","Select","Select",""],["","","PAXLOVID (EUA)","","","Select","Select",""],["","","NEO\/POLYMYX\/HYDROCORTISONE","","","Select","Select",""],["","","IPRATROPIUM","0.0006","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","PREVNAR","","","Select","Select",""],["","","ERYTHROMYCIN","0.005","","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":""}]}]}