{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steve B Allen","gend":0,"currentgend":"","add":"59 TIMBERLEDGE LANE","city":"BLUE HILL","state":"ME","zip":"04614","dob":"1955-04-18","age":"","mstatus":"","insh":"10000078480","cliId":"","pno":"2074600520","cno":"","email":"sballen51@yahoo.com","ename":"","eno":"","pphy":"TAINTER, RUTH B","ppno":"2076672288","pcpadd":"Bucksport Regional Health Center,37 Commerce Park","pcpcity":"Bucksport","pcpstate":"ME","pcpzip":"04416","pcpcounty":"","pcpid":"","pcpname":"BUCKSPORT REGIONAL HEALTH CENTER","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"59 TIMBERLEDGE LANE","madd2":"","madd3":"","mcity":"BLUE HILL","mstate":"ME","mzip":"04614","pcpfaxno":"2076676888","pcpnpi":"1134438625","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5Y31WE8DQ34","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["J4550","R194","R198","G4733","E1169","J3081","J329","J4540","K5730","Z888","I129","E119","Z0101","H35373","H40033","I4819","I2510","Z7982","Z95818","Z1211","I4891","I10","J449","J069","M109","R079","R0789","R110","J9811","R0602","I214","H539","K219","E669","J3089","J4530","R519","H538","H353132","R109","H43811","Z01810","I252","Z9884","Z87891","Z79899","E6601","I25110","H278","R932","Z98890","Z48815","R7989","Z6835","Z23","R945","J45901"],"date":["2025-10-28","2023-06-02","2023-05-08","2026-02-28","2025-10-29","2023-05-30","2025-12-16","2025-07-07","2023-06-02","2023-06-02","2023-06-02","2025-12-29","2024-11-20","2025-10-02","2023-04-17","2023-08-17","2025-01-03","2026-01-12","2026-01-25","2023-05-08","2026-02-04","2025-12-29","2024-03-19","2024-03-19","2024-06-10","2026-01-11","2024-06-13","2024-06-13","2024-06-30","2024-06-30","2024-06-15","2025-07-08","2025-12-29","2025-10-29","2025-12-16","2025-12-16","2024-07-01","2024-07-01","2025-10-02","2025-05-06","2025-05-01","2025-11-24","2025-04-21","2025-04-21","2026-01-25","2026-01-12","2025-12-18","2024-08-05","2025-06-19","2025-10-29","2026-01-08","2025-06-02","2025-09-08","2023-03-24","2025-03-24","2025-10-29","2024-03-19"],"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":[["","","PREDNISONE","20 MG","","Select","Select",""],["","","OMEPRAZOLE","10 MG","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","RANOLAZINE","500 MG","","Select","Select",""],["","","PROCHLORPERAZINE","10 MG","","Select","Select",""],["","","MOUNJARO","","","Select","Select",""],["","","COLCHICINE","0.6 MG","","Select","Select",""],["","","CARVEDILOL","12.5 MG","","Select","Select",""],["","","PRASUGREL","10 MG","","Select","Select",""],["","","BRILINTA","","","Select","Select",""],["","","ISOSORBIDE MONONITRATE","30 MG","","Select","Select",""],["","","NIFEDIPINE","30 MG","","Select","Select",""],["","","AMLODIPINE","10 MG","","Select","Select",""],["","","Peg 3350\/Electrolytes","420 GM","","Select","Select",""],["","","Ezetimibe","10 MG","","Select","Select",""],["","","NITROGLYCERIN","0.4 MG","","Select","Select",""],["","","AREXVY","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","CLONIDINE","0.1 MG","","Select","Select",""],["","","ALLOPURINOL","100 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","METOPROLOL SUCC","25 MG","","Select","Select",""],["","","FUROSEMIDE","20 MG","","Select","Select",""],["","","REPATHA SURECLICK","","","Select","Select",""],["","","CHLORTHALIDONE","25 MG","","Select","Select",""],["","","OZEMPIC","","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","METFORMIN","500 MG","","Select","Select",""],["","","Albuterol 0.083%","2.5 MG","","Select","Select",""],["","","TRELEGY ELLIPTA","","","Select","Select",""],["","","Fluzone High-Dose Quad 2023-24","","","Select","Select",""],["","","FASENRA","","","Select","Select",""],["","","INDOMETHACIN","25 MG","","Select","Select",""],["","","XARELTO","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","OXYBUTYNIN","5 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE QUAD","","","Select","Select",""],["","","PEG","3350\/ELECTROLYTES 420","","Select","Select",""],["","","ALBUTEROL (","0.083%) 2.5","","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":""}]}]}