{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David I Robinson","gend":0,"currentgend":"","add":"605 OAK ST","city":"SANFORD","state":"ME","zip":"04073","dob":"1942-03-24","age":"","mstatus":"","insh":"10000098634","cliId":"","pno":"2074675960","cno":"","email":"declined@10232025.com","ename":"","eno":"","pphy":"MEADOWS, RHIANNA M","ppno":"","pcpadd":"840 E MCKELLIPS RD,SUITE 101","pcpcity":"MESA","pcpstate":"AZ","pcpzip":"85203964","pcpcounty":"","pcpid":"","pcpname":"NASSON HEALTH CARE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 1264","madd2":"","madd3":"","mcity":"SANFORD","mstate":"ME","mzip":"04073","pcpfaxno":"4808338313","pcpnpi":"1194988311","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6NE6DX0GQ64","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["S60552A","C438","Z79899","S61442D","C602","I10","D649","R310","Z5112","N179","Z0101","H5203","R339","C609","N1330","N3289","N400","J929","J9811","N401","L270","K5730","K4020","J984","C675","R338","N320","C61","S76212A","R197","N200","R112","K635","K5100","N201","N136","D1339","K630","N202","R4182","Z466","K5289","C439","E279","K828","R531","R634","M6281","I493","R9431","R399","N281","K8020","Z0000","N3090","J8410","N3000","S8001XA","Z87891","M25461","M25462","M25561","M25562","M1711","R2689","I5020","I517","I361","R5383","R42","R682","Z515","R918","Z5111","C4359"],"date":["2023-04-15","2026-02-12","2025-12-09","2023-04-17","2026-02-12","2025-12-09","2024-04-29","2023-07-11","2024-05-20","2024-02-26","2025-04-30","2025-04-30","2024-02-26","2025-03-10","2023-07-10","2023-07-10","2023-07-10","2023-07-10","2023-07-10","2024-03-19","2023-10-31","2023-10-23","2023-10-23","2024-05-17","2023-11-03","2023-11-03","2023-11-03","2024-05-28","2024-02-15","2024-03-19","2024-03-17","2024-03-19","2024-03-19","2024-03-19","2025-08-20","2024-03-16","2024-03-19","2024-03-19","2024-04-25","2024-04-25","2024-05-01","2024-06-10","2024-07-02","2024-07-02","2024-07-02","2025-05-13","2026-02-10","2026-02-10","2025-03-07","2025-03-07","2025-08-20","2024-08-03","2024-11-11","2025-12-09","2024-12-10","2023-03-27","2025-01-09","2024-08-30","2024-08-30","2024-10-15","2024-10-15","2024-10-14","2024-10-14","2024-10-13","2024-10-13","2025-05-08","2025-05-08","2025-05-08","2025-08-28","2024-10-12","2024-10-12","2026-02-12","2023-03-27","2026-02-10","2023-02-02"],"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":[["","","Mirtazapine","7.5 MG","","Select","Select",""],["","","Olmesartan","20 MG","","Select","Select",""],["","","Prednisone","5 MG","","Select","Select",""],["","","Tamsulosin","0.4 MG","","Select","Select",""],["","","Sulfamethoxazole\/Trimethoprim","800\/160 MG","","Select","Select",""],["","","Cephalexin","500 MG","","Select","Select",""],["","","Shingrix","","","Select","Select",""],["","","Potassium Cl","20 MEQ","","Select","Select",""],["","","Cefdinir","300 MG","","Select","Select",""],["","","Hydrocortisone 1 % Rec Cream Ani Pharm","","","Select","Select",""],["","","Pantoprazole","20 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Padagis","","","Select","Select",""],["","","Olmesartan Medoxomil","","","Select","Select",""],["","","Neo\/Polymyx\/Dex 3.5\/10","","","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":""}]}]}