{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"James E Harris","gend":0,"currentgend":"","add":"13 STONELEDGE DR","city":"Portland","state":"ME","zip":"04102","dob":"1940-12-14","age":"","mstatus":"","insh":"10000071021","cliId":"","pno":"2072520996","cno":"","email":"engineroom398@gmail.com","ename":"","eno":"","pphy":"SKVORAK, KASSIE A","ppno":"2077998596","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":"13 STONELEDGE DR","madd2":"","madd3":"","mcity":"Portland","mstate":"ME","mzip":"04102","pcpfaxno":"2077991730","pcpnpi":"1316496052","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5UA2GQ4EM88","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":["E039","E782","Z125","I10","Z23","Z0101","R6889","M9901","M531","M9902","S233XXA","M9907","R55","D044","H33301","H43813","R5383","I498","I4510","I25119","R9439","K7689","I088","I77810","I2510","Z01810","I6523","G4730","I25118","I2584","K7460","E669","E785","M7981","I97630","K2970","K259","Z87891","Z955","R059","R053","G4733","D5912","K219","E7800","R310","R918","N200","K7469","R051","N3289","D090","R079","I70211","I739","N400","Z8551","I5042","I214","C672","C679","H2513","I25110","I200","H2511","Z720","I452","Z7982","R350","M9903","S335XXA","M9904","M9905","H2512","R509","L570","K7581"],"date":["2025-08-12","2025-05-07","2025-05-07","2026-02-27","2024-10-21","2024-12-09","2023-05-03","2023-06-02","2023-06-02","2023-06-02","2023-06-02","2024-05-15","2023-07-11","2023-07-17","2023-08-16","2023-08-16","2023-11-08","2023-12-06","2023-12-06","2024-03-27","2024-02-29","2024-09-04","2026-02-18","2026-02-27","2026-02-27","2024-02-23","2024-02-23","2024-02-02","2024-09-03","2024-02-29","2025-09-08","2024-02-28","2025-08-12","2024-03-06","2024-03-06","2024-02-28","2024-02-28","2024-02-22","2024-12-02","2025-09-17","2024-05-16","2025-02-28","2024-05-23","2024-05-23","2026-02-27","2025-07-17","2025-09-17","2025-07-31","2026-02-26","2025-09-17","2025-08-12","2025-08-12","2024-09-02","2025-12-08","2025-12-08","2025-11-04","2025-11-04","2025-01-03","2024-09-03","2025-11-04","2025-08-12","2025-04-10","2024-09-04","2024-09-03","2025-04-24","2024-09-03","2024-09-02","2024-09-02","2025-11-08","2024-11-01","2024-11-01","2024-11-01","2024-11-01","2025-05-05","2025-01-29","2025-06-25","2026-03-02"],"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":[["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","Metronidazole 0.75 % Gel Cosette","","","Select","Select",""],["","","LEVOTHYROXINE","50 MCG","","Select","Select",""],["","","MNEXSPIKE","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","ISOSORBIDE MONONITRATE","30 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","OMEPRAZOLE","40 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","LISINOPRIL","20 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","LISINOPRIL\/HYDROCHLOROTHIAZIDE","20\/25 MG","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","SULFAMETHOXAZOLE\/TRIMETHOPRIM","800\/160 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","Ketorolac 0.5 % Ophth Sol Micro Labs","","","Select","Select",""],["","","SIMVASTATIN","20 MG","","Select","Select",""],["","","AMLODIPINE","5 MG","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Lupin","","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","METRONIDAZOLE","0.0075","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","Select","Select",""],["","","KETOROLAC","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":""}]}]}