{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gary A Brown","gend":0,"currentgend":"","add":"4 COTTON RD","city":"LISBON","state":"ME","zip":"04250","dob":"1956-08-03","age":"","mstatus":"","insh":"10000092807","cliId":"","pno":"2073539007","cno":"2072127785","email":"","ename":"","eno":"","pphy":"SKELTON, SARAH K","ppno":"2077847388","pcpadd":"Family Health Care Associates,190 Stetson Rd","pcpcity":"Auburn","pcpstate":"ME","pcpzip":"04210","pcpcounty":"","pcpid":"","pcpname":"FAMILY HEALTH CARE ASSOCIATES","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"4 COTTON RD","madd2":"","madd3":"","mcity":"LISBON","mstate":"ME","mzip":"04250","pcpfaxno":"2077952043","pcpnpi":"1861489882","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"5MQ1X05VC02","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["C61","I7120","I77819","I517","K449","I10","Z510","Z08","Z8546","Z923","Z0000","E782","L821","R319","K921","K5730","K648","K627","M6780","E669","I7121","S82861D","Z98890","Z79811","S82841A","S82861A","G8918","Z01818","S8251XA","S93432A","S0990XA","W000XXA","S8261XA","S82891A","S82431A","S82301A","R739","C775"],"date":["2026-03-02","2023-05-09","2025-03-04","2023-05-16","2023-05-16","2026-03-02","2023-08-15","2024-05-15","2024-05-15","2024-05-15","2025-09-02","2026-03-02","2024-03-26","2024-06-04","2024-08-20","2024-08-20","2024-08-20","2024-08-20","2026-03-02","2025-09-02","2025-01-31","2023-03-27","2023-03-27","2025-02-03","2023-03-04","2023-03-09","2023-03-09","2023-03-07","2023-03-04","2023-03-09","2023-03-04","2023-03-04","2023-03-04","2023-03-04","2023-03-04","2023-03-04","2023-02-10","2023-01-24"],"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":[["","","POTASSIUM CL","20 MEQ","","Select","Select",""],["","","ABIRATERONE","250 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","LOSARTAN","100 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","PREDNISONE","5 MG","","Select","Select",""],["","","Prevnar 20","","","Select","Select",""],["","","Gavilyte-N","","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","Flucelvax Quad 2023-2024","","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","PREVNAR","","","Select","Select",""],["","","FLUCELVAX QUAD","","","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":""}]}]}