{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Gary L Davis","gend":0,"currentgend":"","add":"301 SOUTH MAIN ST","city":"SOLON","state":"ME","zip":"04979","dob":"1958-05-06","age":"","mstatus":"","insh":"10000093026","cliId":"","pno":"2076432515","cno":"","email":"gray_58@yahoo.com","ename":"","eno":"","pphy":"MALYK, TIMOTHY C","ppno":"2074743320","pcpadd":"Redington Family Practice,46 Fairview Ave Ste 111","pcpcity":"Skowhegan","pcpstate":"ME","pcpzip":"04976","pcpcounty":"","pcpid":"","pcpname":"REDINGTON FAMILY PRACTICE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"301 SOUTH MAIN ST","madd2":"","madd3":"","mcity":"SOLON","mstate":"ME","mzip":"04979","pcpfaxno":"2074749261","pcpnpi":"1225035512","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7GG1W45MG19","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["E119","M5416","R55","R21","Z125","M25511","Z0000","Z981","M4722","G629","G609","E1142","E11621","M79674","G5603","G5623","M2021","E1140","M5116","M47816","Z0101","R059","M4802","Z1211","Z1212","H6121","M19071","Z98890","I10","M2011","E782","M11232","E1149","G9009"],"date":["2025-04-29","2024-10-07","2023-05-31","2023-09-21","2023-10-11","2023-11-16","2025-11-12","2024-01-09","2024-02-08","2024-02-08","2025-10-17","2024-10-15","2025-04-28","2025-09-15","2024-12-13","2024-12-13","2025-05-21","2024-07-03","2025-09-10","2025-09-16","2025-09-18","2024-11-20","2024-07-22","2025-07-13","2025-07-13","2024-08-18","2025-05-12","2025-07-10","2025-04-14","2025-03-31","2024-10-28","2026-01-23","2025-12-15","2023-02-08"],"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":[["","","Rybelsus (Formulation R1)","","","Select","Select",""],["","","GABAPENTIN","300 MG","","Select","Select",""],["","","ROSUVASTATIN","5 MG","","Select","Select",""],["","","AMOXICILLIN\/CLAV","875\/125 MG","","Select","Select",""],["","","Clotrimazole 1 % Cream Taro","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Encube","","","Select","Select",""],["","","Ammonium Lac 12 % Lotion Taro","","","Select","Select",""],["","","LOSARTAN\/HYDROCHLOROTHIAZIDE","100\/25 MG","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","LOSARTAN-HYDROCHLOROTHIAZIDE","","","Select","Select",""],["","","PREDNISONE","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Ascend Labs","","","Select","Select",""],["","","ATENOLOL","25 MG","","Select","Select",""],["","","ALBUTEROL HFA","90 MCG","","Select","Select",""],["","","AMMONIUM LAC","0.12","","Select","Select",""],["","","RYBELSUS (FORMULATION R","","","Select","Select",""],["","","NYSTATIN","","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","CLOTRIMAZOLE","0.01","","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":""}]}]}