{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Daniel J Mcgillicuddy","gend":0,"currentgend":"","add":"38 COUNTY RD","city":"GORHAM","state":"ME","zip":"04038","dob":"1947-01-12","age":"","mstatus":"","insh":"10000051773","cliId":"","pno":"2077452222","cno":"","email":"djmcgillicuddy47@aol.com","ename":"","eno":"","pphy":"CATHCART, SCOTT","ppno":"2077745816","pcpadd":"Intermed,84 Marginal Way Ste 700","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"38 COUNTY RD","madd2":"","madd3":"","mcity":"GORHAM","mstate":"ME","mzip":"04038","pcpfaxno":"","pcpnpi":"1659876571","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2KY4A01RC99","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I480","Z125","E1165","Z0000","Z23","E11649","E1142","E1159","Z794","L570","E1169","E782","E781","E118","Z0100","E1122","H903","I10","Z7901","Z7984","E1121","M109","D62","Z0101","M25611","J069","M25511","M6281","M25811","E790","K921","E669","I4891","K219","K5731","D649","E785","D500","R933","K644","K922","R55","M19041","R109","I700","I708","D693","Z09","R578","R7989","Z0001","H6121","M19042","M79642","M79641","M7910"],"date":["2026-02-09","2023-06-02","2026-02-09","2024-06-27","2025-09-09","2023-09-19","2024-07-15","2025-05-08","2025-11-06","2025-07-03","2025-05-08","2025-05-08","2025-05-08","2024-07-15","2024-11-07","2025-07-31","2025-03-07","2025-09-25","2024-05-10","2025-11-06","2025-11-06","2025-08-13","2025-11-01","2025-11-12","2025-03-17","2025-12-29","2025-03-17","2025-03-17","2025-03-17","2025-07-31","2025-08-08","2025-08-06","2025-08-06","2025-08-06","2025-08-13","2025-08-08","2025-08-08","2025-08-07","2025-08-07","2025-08-07","2025-08-07","2025-08-06","2024-10-23","2025-08-06","2025-08-04","2025-08-04","2025-02-24","2025-08-13","2025-08-07","2025-08-18","2025-07-03","2025-07-03","2025-07-31","2024-10-23","2024-10-23","2024-10-23"],"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":[["","","JANTOVEN","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Taro","","","Select","Select",""],["","","PRAVASTATIN","20 MG","","Select","Select",""],["","","COLCHICINE","0.6 MG","","Select","Select",""],["","","TRESIBA FLEXTOUCH","","","Select","Select",""],["","","GLIPIZIDE","10 MG","","Select","Select",""],["","","EZETIMIBE","10 MG","","Select","Select",""],["","","ONETOUCH VERIO","","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","NOVOLOG FLEXPEN","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ALLOPURINOL","100 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","Bd Ultra-Fine Mini (Ref 320119)","","","Select","Select",""],["","","METHOCARBAMOL","500 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","FLEXTOUCH","","","Select","Select",""],["","","JANUVIA","","","Select","Select",""],["","","BD ULTRA-FINE MINI (REF","","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","DEXCOM G","","","Select","Select",""],["","","PREVNAR","","","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":""}]}]}