{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"David L Miller","gend":0,"currentgend":"","add":"65 MCAULEY WAY UNIT 203","city":"PORTLAND","state":"ME","zip":"04103","dob":"1954-12-24","age":"","mstatus":"","insh":"10000112075","cliId":"","pno":"2073219168","cno":"8667674542","email":"dlivingstonemiller@gmail.com","ename":"","eno":"","pphy":"LENA, SEAN R","ppno":"2077745816","pcpadd":"InterMed,84 Marginal Way Ste 800","pcpcity":"Portland","pcpstate":"ME","pcpzip":"04101","pcpcounty":"","pcpid":"","pcpname":"INTERMED","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"65 MCAULEY WAY UNIT 203","madd2":"","madd3":"","mcity":"PORTLAND","mstate":"ME","mzip":"04103","pcpfaxno":"2078741483","pcpnpi":"1265895502","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"1AD5FY5QU85","medicaidid":"","pcpFlag":""},{"a":{"indx":["1","","","","","","",""],"comment":["","","","","","","",""],"sub":[]}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["Z0000","I10","E782","Z1211","L2089","M5450","R21","D485","Z0001","H6122","L309","L578","H5203","H2513"],"date":["2025-03-17","2026-02-02","2026-02-02","2024-10-14","2026-01-26","2025-05-09","2025-07-30","2025-07-30","2026-01-30","2026-01-30","2025-12-12","2025-12-12","2025-05-12","2025-05-12"],"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","500 MG","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Cream Macleods","","","Select","Select",""],["","","Chlorhexidine 0.12 % Oral Rinse Rising","","","Select","Select",""],["","","FLUAD","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","Triamcinolone Acet 0.1 % Ointment Fougera","","","Select","Select",""],["","","DUPIXENT","","","Select","Select",""],["","","LISINOPRIL","40 MG","","Select","Select",""],["","","ATORVASTATIN","10 MG","","Select","Select",""],["","","PREDNISONE","10 MG","","Select","Select",""],["","","HYDROCODONE\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","Clobetasol 0.05 % Ointment Encube","","","Select","Select",""],["","","Clotrimazole 1 % Cream Glenmark","","","Select","Select",""],["","","HYDROCHLOROTHIAZIDE","50 MG","","Select","Select",""],["","","FLUBLOK","","","Select","Select",""],["","","Fluorouracil 5 % Cream Taro","","","Select","Select",""],["","","CLOTRIMAZOLE","0.01","","Select","Select",""],["","","TRIAMCINOLONE ACET","0.001","","Select","Select",""],["","","CLOBETASOL","0.0005","","Select","Select",""],["","","CHLORHEXIDINE","0.0012","","Select","Select",""],["","","FLUOROURACIL","0.05","","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":""}]}]}