{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Donald O Nevells","gend":0,"currentgend":"","add":"21 LILY LANE","city":"BANGOR","state":"ME","zip":"04401","dob":"1952-04-27","age":"","mstatus":"","insh":"10000058147","cliId":"","pno":"2073567062","cno":"","email":"SDNEVELLS@GMAIL.COM","ename":"","eno":"","pphy":"DOCKERY, CRYSTAL A","ppno":"","pcpadd":"PO BOX 1599,","pcpcity":"BANGOR","pcpstate":"ME","pcpzip":"44021599","pcpcounty":"","pcpid":"","pcpname":"ST JOSEPH FAMILY MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"21 LILY LANE","madd2":"","madd3":"","mcity":"BANGOR","mstate":"ME","mzip":"04401","pcpfaxno":"2079470435","pcpnpi":"1114347069","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4RG1K22YJ91","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["M25511","M25611","R531","M7918","N281","E119","M25519","M546","L602","Z0101","H52223","G4733","E1100","G2401","M5450","W19XXXA","G629","M47816","G8929","I340","I3481","I517","E1165","Z794","E1122","N1831","E237","S46011A","F332","R9720","I10","E782","C61","M5442","M5441","M549","R0781","Z9181","M7521","M75111","M25411","Z739","Z0000","M47814","M48061","M19011","R55","E236","M170","C641","E6601","M9909","R911","K219","R634","L820","B078","D225","L821","L814","Z7189","M51360","R296","R110","Z79891","H903","I480","D120","D122","D123","N401","N138","E781","Z13810"],"date":["2026-02-19","2026-02-19","2026-02-19","2025-04-29","2025-09-26","2025-12-01","2025-12-01","2025-01-02","2025-12-29","2025-03-06","2025-03-06","2026-01-27","2025-10-29","2026-02-27","2025-10-29","2025-01-02","2025-06-04","2025-08-29","2026-03-13","2025-04-10","2025-04-10","2025-04-10","2025-03-04","2025-12-29","2025-12-29","2025-12-29","2025-09-09","2025-08-21","2025-12-01","2025-11-12","2025-04-23","2025-03-28","2025-11-12","2026-03-13","2026-03-13","2025-01-17","2025-05-19","2025-05-19","2025-09-08","2025-12-19","2025-12-19","2025-03-17","2026-03-02","2025-04-29","2025-08-29","2025-08-12","2025-04-10","2025-10-24","2025-04-21","2025-04-29","2025-07-16","2025-07-16","2025-02-10","2025-02-20","2025-02-20","2025-05-08","2025-05-08","2025-05-08","2025-05-08","2025-05-08","2025-05-08","2025-12-04","2025-12-04","2026-03-02","2026-02-04","2025-11-19","2025-05-15","2025-02-20","2025-02-20","2025-02-20","2025-11-12","2025-11-12","2025-01-30","2025-02-20"],"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":[["","","Dexcom G6 Transmitter","","","Select","Select",""],["","","OXYCODONE HCL\/ACETAMINOPHEN","7.5\/325 MG","","Select","Select",""],["","","DUTASTERIDE","0.5 MG","","Select","Select",""],["","","Levofloxacin","500 MG","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","SILODOSIN","8 MG","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","DILTIAZEM","120 MG","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","Pregabalin","150 MG","","Select","Select",""],["","","Prazosin","2 MG","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","ROSUVASTATIN","10 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","TRULICITY","","","Select","Select",""],["","","Dexcom G6 Receiver (Ref Stk-Oe-001)","","","Select","Select",""],["","","TRINTELLIX","","","Select","Select",""],["","","FLECAINIDE","150 MG","","Select","Select",""],["","","BD ULTRA-FINE MICRO","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","Clonidine","0.1 MG","","Select","Select",""],["","","ONETOUCH ULTRA BLUE","","","Select","Select",""],["","","SOLIFENACIN","10 MG","","Select","Select",""],["","","Dexcom G6 Sensor","","","Select","Select",""],["","","TOUJEO MAX SOLOSTAR","","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","Bd Ultra-Fine Mini (Ref 320119)","","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","Embecta Ultra-Fine (Ref 320119)","","","Select","Select",""],["","","Austedo Xr Titration Kit","","","Select","Select",""],["","","Bd Ultra-Fine Nano (Ref 320122)","","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","Methocarbamol","750 MG","","Select","Select",""],["","","BASAGLAR KWIKPEN","","","Select","Select",""],["","","BUPRENORPHINE","5 MCG\/HR","","Select","Select",""],["","","Dexcom G7 Sensor","","","Select","Select",""],["","","Dexcom G7 Receiver (Ref Stk-At-012)","","","Select","Select",""],["","","GAVILYTE-N","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","Promethazine","25 MG","","Select","Select",""],["","","ONETOUCH DELICA PLUS","","","Select","Select",""],["","","TIZANIDINE","2 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","VASCEPA","","","Select","Select",""],["","","FENOFIBRATE","","","Select","Select",""],["","","Metformin 1","","","Select","Select",""],["","","OXYCODONE-ACETAMINOPHEN","","","Select","Select",""],["","","DEXCOM G","6 RECEIVER","","Select","Select",""],["","","BD ULTRA-FINE MINI (REF","","","Select","Select",""],["","","EMBECTA ULTRA-FINE (REF","","","Select","Select",""],["","","PEG","3350\/ELECTROLYTES 420","","Select","Select",""],["","","BD ULTRA-FINE NANO (REF","","","Select","Select",""],["","","METFORMIN","","","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":""}]}]}