{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"William G Regan","gend":0,"currentgend":"","add":"292 BAUNEG BEG RD","city":"SANFORD","state":"ME","zip":"04073","dob":"1953-10-31","age":"","mstatus":"","insh":"10000122381","cliId":"","pno":"6036600147","cno":"","email":"billreganaxis@gmail.com","ename":"","eno":"","pphy":"STUKALAU, IVAN","ppno":"","pcpadd":"WHP Internal Medicine,10 Members Way Fl 5","pcpcity":"Dover","pcpstate":"NH","pcpzip":"03820","pcpcounty":"","pcpid":"","pcpname":"WHP INTERNAL MEDICINE","plan":"Martin's Point","program":"Medicare","lob":"GA - Wave 2","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"292 BAUNEG BEG RD","madd2":"","madd3":"","mcity":"SANFORD","mstate":"ME","mzip":"04073","pcpfaxno":"","pcpnpi":"1235701202","currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"6WC4GC9ED72","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["R000","I440","I25118","Z95810","I2510","I4510","R001","R079","I214","G4700","I10","I82622","I4720","Z951","Z87898","R0789","Z87891","R4182","R9431","G894","Z5181","Z79891","J90","Z98890","Z48812","R918","I499","R0989","J811","I77810","M4727","M51362","M4697","M62838","Z01810","Z950","I25110","M4726","I509","I129","T50905A","E079","Z79899","T829XXA","M129","M19119","S91312A","W228XXA","M47816","M47817","M48061","H903","I493","Z0101","H524","I6523"],"date":["2025-12-17","2025-06-11","2025-06-11","2025-07-28","2025-09-24","2025-06-15","2025-06-15","2025-06-13","2025-06-13","2025-06-16","2025-07-28","2025-03-19","2025-06-16","2025-10-01","2025-06-14","2025-06-12","2025-06-12","2025-10-02","2025-06-15","2025-12-10","2025-12-10","2025-12-10","2025-06-22","2025-06-19","2025-07-27","2025-11-20","2025-06-16","2025-06-20","2025-06-18","2025-11-20","2025-05-01","2025-05-01","2025-05-01","2025-05-01","2025-06-14","2025-06-14","2025-06-13","2025-12-10","2025-07-28","2025-06-27","2025-10-02","2025-10-02","2025-10-02","2025-01-21","2025-01-08","2025-01-08","2025-08-15","2025-08-15","2025-08-18","2025-08-18","2025-08-18","2025-01-28","2025-09-08","2026-01-16","2026-01-16","2025-10-02"],"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":[["","","XARELTO","","","Select","Select",""],["","","ZOLPIDEM","10 MG","","Select","Select",""],["","","AMIODARONE","200 MG","","Select","Select",""],["","","FLUZONE HIGH-DOSE","","","Select","Select",""],["","","ABRYSVO ACT-O-VIAL","","","Select","Select",""],["","","COMIRNATY","","","Select","Select",""],["","","OXYCODONE HCL\/ACETAMINOPHEN","5\/325 MG","","Select","Select",""],["","","AMLODIPINE","10 MG","","Select","Select",""],["","","CEPHALEXIN","500 MG","","Select","Select",""],["","","Gabapentin","300 MG","","Select","Select",""],["","","METOPROLOL TART","25 MG","","Select","Select",""],["","","LOSARTAN","50 MG","","Select","Select",""],["","","FLUZONE HIGH DOSE","","","Select","Select",""],["","","ELIQUIS","","","Select","Select",""],["","","AMOXICILLIN","500 MG","","Select","Select",""],["","","FUROSEMIDE","40 MG","","Select","Select",""],["","","ATORVASTATIN","80 MG","","Select","Select",""],["","","PANTOPRAZOLE","40 MG","","Select","Select",""],["","","BOOSTRIX","","","Select","Select",""],["","","ABRYSVO W\/ DILUENT SYRINGE","","","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":""}]}]}