{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"William T Oliver","gend":0,"currentgend":"","add":"94 NEAL ST","city":"PORTLAND","state":"ME","zip":"04102","dob":"1942-09-01","age":"","mstatus":"","insh":"10000093921","cliId":"","pno":"3105692121","cno":"","email":"anngaryoliver@gmail.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":"94 NEAL ST","madd2":"","madd3":"","mcity":"PORTLAND","mstate":"ME","mzip":"04102","pcpfaxno":"2078287850","pcpnpi":"1619918307","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2RG4VE7CA64","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":["H401131","E785","H2513","R42","I10","N200","N393","I2510","I6523","I771","Z125","H6123","I6782","G459","R6889","D122","A419","R262","D492","M21372","M6281","R2681","Z9181","M5431","D72829","R600","H2511","H401111","L570","I776","A409","G7281","H903","D123","D125","K5730","I7143","M25551","I791","D0359","S0181XA","S0990XA","Z23","M19012","R7881","B954","I7140","D225","L821","L905","Z85820","A408","I5022","R9439","I719","E861","R4182","I082","R059","G8918","Z4682","J982","J90","H2512","H401121","R109","R931","I700","Z4659","J181","J939","Z452","R918","K8020","N281","R634","M609","A403","M25572","I701","I708","M5450","E7800","D0339","Z4802","R94131","Z01810"],"date":["2025-12-11","2024-07-29","2025-06-10","2026-03-03","2026-03-03","2025-07-23","2024-06-20","2026-03-03","2025-03-07","2024-01-30","2024-02-20","2025-07-17","2024-03-18","2024-03-18","2023-05-20","2025-03-28","2025-09-02","2025-10-21","2025-03-20","2026-03-03","2026-03-03","2026-03-03","2026-03-03","2026-02-25","2025-07-17","2025-12-09","2025-11-06","2025-11-06","2025-03-20","2025-08-20","2025-08-20","2025-08-06","2024-12-26","2025-03-28","2025-03-28","2025-07-23","2025-09-22","2024-11-08","2025-08-06","2025-04-29","2025-09-11","2025-09-11","2025-09-11","2025-09-11","2025-08-30","2025-08-30","2025-09-15","2025-09-16","2025-09-16","2025-09-16","2025-09-16","2025-09-18","2026-03-03","2025-04-18","2025-08-01","2025-08-01","2025-07-30","2025-07-28","2025-02-10","2025-08-04","2025-08-02","2025-08-02","2025-08-02","2025-12-11","2025-12-11","2025-08-06","2025-07-28","2025-07-28","2025-07-30","2025-07-31","2025-07-31","2025-07-31","2025-07-31","2025-07-23","2025-07-23","2025-02-10","2025-07-31","2025-07-26","2025-07-28","2025-07-23","2025-07-23","2024-07-29","2025-03-07","2025-03-20","2025-09-18","2025-12-10","2025-07-28"],"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":[["","","Mupirocin 2 % Ointment Teva","","","Select","Select",""],["","","OXYCODONE HCL","5 MG","","Select","Select",""],["","","Latanoprost 0.005 % Ophth Sol B&L","","","Select","Select",""],["","","Moxifloxacin 0.5 % Ophth Sol Lupin","","","Select","Select",""],["","","Prednisolone Ace 1 % Ophth Susp Pacific","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Macleods","","","Select","Select",""],["","","DOXYCYCLINE MONOHYDRATE","100 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","Spikevax 2023-2024","","","Select","Select",""],["","","ALPRAZOLAM","0.5 MG","","Select","Select",""],["","","AMLODIPINE","10 MG","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","TRAZODONE","50 MG","","Select","Select",""],["","","AMOXICILLIN","875 MG","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","25 MG","","Select","Select",""],["","","PAXLOVID","300\/100 MG","","Select","Select",""],["","","TELMISARTAN","80 MG","","Select","Select",""],["","","Fluad Quad 2023-2024","","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","Select","Select",""],["","","Sodium Fluoride 5000 Ppm Dry Mouth","","","Select","Select",""],["","","AZITHROMYCIN","250 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LATANOPROST","0.00005","","Select","Select",""],["","","MOXIFLOXACIN","0.005","","Select","Select",""],["","","FLUAD QUAD","","","Select","Select",""],["","","PREDNISOLONE ACE","0.01","","Select","Select",""],["","","MUPIROCIN","0.02","","Select","Select",""],["","","SPIKEVAX","","","Select","Select",""],["","","SODIUM FLUORIDE","5000 PPM","","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":""}]}]}