{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David S Cline","gend":0,"currentgend":"","add":"7 SPRING ST","city":"YARMOUTH","state":"ME","zip":"04096","dob":"1954-05-08","age":"","mstatus":"","insh":"10000067918","cliId":"","pno":"2073529166","cno":"","email":"dpcline@twc.com","ename":"","eno":"","pphy":"PIERCE, DANIEL C","ppno":"2078469013","pcpadd":"InterMed,259 Main St","pcpcity":"Yarmouth","pcpstate":"ME","pcpzip":"04096","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"7 SPRING ST","madd2":"","madd3":"","mcity":"YARMOUTH","mstate":"ME","mzip":"04096","pcpfaxno":"2078741483","pcpnpi":"1861451080","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1QN9AH5HM57","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["H2513","C439","M542","J40","R062","L570","Z85820","D225","L578","L814","C4362","D509","E782","Z125","Z23","Z0000","M25551","M5450","M1611","M25511","K449","J9811","I10","R6889","M75121","M19011","M25411","S46011A","W000XXA","M25811","M6281","E785","G8918","M160","Z471","Z96641","M25559","Z98890","Z01818","M533","G8929","I7121","Z4789","J111","J069","Z03818","M461","M47816","L03019","D62","D7589","K921","M47896","D649","R4182","M5126","M47817","M4317","K264","K922","K429","K4090","K5730"],"date":["2025-07-29","2025-07-29","2023-06-01","2023-06-12","2023-06-12","2025-08-26","2024-07-31","2025-02-12","2025-02-12","2025-02-12","2025-11-04","2025-11-11","2025-11-11","2025-11-11","2025-12-16","2025-11-19","2025-01-20","2025-11-13","2025-01-20","2024-12-19","2024-02-05","2025-03-06","2024-06-28","2023-10-24","2024-04-29","2024-04-11","2024-03-10","2024-04-11","2024-04-11","2024-08-12","2025-01-20","2024-08-20","2024-04-29","2024-05-29","2025-07-09","2026-02-04","2024-05-29","2024-12-19","2024-07-23","2026-02-09","2026-02-09","2025-03-06","2025-01-20","2025-02-21","2025-02-21","2025-02-21","2026-02-04","2026-02-04","2025-10-15","2024-09-03","2024-09-06","2024-09-16","2025-10-15","2024-08-20","2024-08-20","2025-09-06","2025-09-06","2025-09-06","2024-09-02","2024-09-03","2023-01-27","2023-01-27","2023-01-27"],"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":[["","","HYDROMORPHONE","2 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","CLINDAMYCIN","300 MG","","Select","Select",""],["","","LISINOPRIL","5 MG","","Select","Select",""],["","","CYCLOBENZAPRINE","5 MG","","Select","Select",""],["","","ACETAMINOPHEN\/CODEINE PHOS","300\/30 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","DEXAMETHASONE","2 MG","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Ascend Labs","","","Select","Select",""],["","","CELECOXIB","200 MG","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","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":""}]}]}