{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Michael Harriman","gend":0,"currentgend":"","add":"31 WINDSWEPT DR","city":"GORHAM","state":"ME","zip":"04038","dob":"1959-11-08","age":"","mstatus":"","insh":"10000105812","cliId":"","pno":"2076714996","cno":"","email":"brshirley65@gmail.com","ename":"","eno":"","pphy":"DEGRINNEY, JOSEPH T","ppno":"2078833491","pcpadd":"301 US ROUTE 1,BUILDING C","pcpcity":"SCARBOROUGH","pcpstate":"ME","pcpzip":"40747609","pcpcounty":"","pcpid":"","pcpname":"MAINEHEALTH PRIMARY CARE INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"31 WINDSWEPT DR","madd2":"","madd3":"","mcity":"GORHAM","mstate":"ME","mzip":"04038","pcpfaxno":"2073968632","pcpnpi":"1538106679","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"8J74GV4KD60","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["N401","R399","N138","E113299","E785","I10","E230","G4733","G40909","F09","G40109","I480","F3340","R4189","E113211","Z0101","H5340","H53451","H5053","H5111","H53143","R6889","R350","Z8669","R569","E11319","R918","R519","G40209","E669","E119","R9401","I4891","Z7901","M9903","M5441","M9902","M546","Z0000","I700","D6869","I3481","N503","N433","E291","Z23","Z125","E538","Z01818","M5450","G8929","D120","D122","K5900","K5730","K5909","R1032","R42","H903","E113313","G9389","F3341","F330","Z5181","M720","N200","Z0100","H2513","Z95818","R8290","Z006","Z7183","Z860101"],"date":["2025-02-24","2023-08-01","2025-02-24","2025-10-17","2025-09-09","2023-10-20","2023-04-05","2025-12-12","2023-10-06","2023-09-12","2025-12-08","2025-10-28","2023-05-16","2025-12-08","2025-06-06","2023-05-31","2023-05-31","2025-05-27","2025-05-27","2025-05-27","2025-05-27","2023-05-26","2023-08-01","2023-10-07","2025-05-22","2023-10-07","2023-10-05","2023-10-05","2023-10-20","2025-09-09","2023-10-20","2023-10-20","2023-10-20","2025-10-28","2024-02-29","2024-02-29","2024-02-29","2024-02-29","2023-11-20","2023-11-20","2023-11-20","2023-11-29","2023-12-08","2023-12-08","2023-12-08","2024-06-26","2024-12-13","2024-01-23","2023-12-14","2024-09-03","2024-09-03","2025-11-03","2025-11-03","2026-01-23","2025-11-03","2025-08-27","2025-08-27","2025-12-08","2025-10-10","2025-06-24","2025-12-01","2026-02-16","2025-06-13","2024-08-01","2025-03-12","2025-08-28","2025-06-06","2025-06-06","2025-10-28","2025-02-24","2025-09-09","2024-10-11","2026-01-23"],"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":[["","","AMOXICILLIN\/CLAV","500\/125 MG","","Select","Select",""],["","","ONDANSETRON","4 MG","","Select","Select",""],["","","LORAZEPAM","0.5 MG","","Select","Select",""],["","","Onetouch Ultra 2","","","Select","Select",""],["","","LACOSAMIDE","200 MG","","Select","Select",""],["","","LISINOPRIL","10 MG","","Select","Select",""],["","","MNEXSPIKE","","","Select","Select",""],["","","FESOTERODINE","4 MG","","Select","Select",""],["","","ESCITALOPRAM","20 MG","","Select","Select",""],["","","Onetouch Ultra","","","Select","Select",""],["","","XCOPRI","","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","TAMSULOSIN","0.4 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","GLIPIZIDE","2.5 MG","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","FLUCELVAX","","","Select","Select",""],["","","TRIAZOLAM","0.25 MG","","Select","Select",""],["","","LACTULOSE","10 GM\/15","","Select","Select",""],["","","CLOPIDOGREL","75 MG","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","Metformin 1","","","Select","Select",""],["","","METFORMIN","","","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":""}]}]}