{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Robert D Brown Jr","gend":0,"currentgend":"","add":"26 CEMETERY RD","city":"Buxton","state":"ME","zip":"04093","dob":"1961-05-15","age":"","mstatus":"","insh":"10000079766","cliId":"","pno":"2072396793","cno":"","email":"declined@02112021.com","ename":"","eno":"","pphy":"PHAN, ANDREW T","ppno":"2078282402","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":"26 CEMETERY RD","madd2":"","madd3":"","mcity":"Buxton","mstate":"ME","mzip":"04093","pcpfaxno":"2078287850","pcpnpi":"1619918307","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"3K90DR8EA28","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":["N1830","E785","E039","M8730","H9211","H903","N1330","N281","N2882","N3289","N2889","C678","R9720","N401","R102","R8289","R9341","C679","D414","K219","I10","C676","C672","R4182","I7771","I6522","R4020","Z48815","I6523","I639","I517","I618","Z8679","F1020","Z8551","R836","R569","D509","Z85818","I6521","F418","R9089","I6503","R739","I708","M8738"],"date":["2025-08-04","2025-08-04","2025-10-22","2025-12-17","2024-05-13","2023-07-19","2023-09-06","2023-09-27","2023-09-06","2023-09-06","2023-09-06","2025-10-20","2025-07-08","2025-07-08","2025-07-08","2023-09-12","2023-09-27","2025-06-03","2024-01-17","2024-01-17","2025-10-22","2024-01-17","2024-01-17","2024-07-29","2026-01-23","2024-05-28","2024-05-27","2024-05-27","2025-10-22","2024-05-29","2024-05-29","2024-05-27","2024-05-29","2024-05-28","2024-10-23","2024-05-29","2024-07-03","2025-11-21","2023-03-21","2025-11-19","2025-10-22","2025-10-22","2025-09-09","2025-08-04","2024-08-23","2025-06-17"],"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":[["","","ARIPIPRAZOLE","5 MG","","Select","Select",""],["","","ATORVASTATIN","40 MG","","Select","Select",""],["","","AMLODIPINE","10 MG","","Select","Select",""],["","","NITROFURANTOIN MACRO\/MONO","100 MG","","Select","Select",""],["","","OMEPRAZOLE","20 MG","","Select","Select",""],["","","LEVETIRACETAM","750 MG","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","PAROXETINE HCL","40 MG","","Select","Select",""],["","","LEVOTHYROXINE","75 MCG","","Select","Select",""],["","","Ciproflox\/Dexameth 0.3\/0.1 % Otic Susp Dr","","","Select","Select",""],["","","NALTREXONE","50 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","CIPROFLOX\/DEXAMETH","0.3\/0.1 %","","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":""}]}]}