{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Shawn E Wilkie","gend":0,"currentgend":"","add":"153 E POND RD","city":"Oakland","state":"ME","zip":"04963","dob":"1957-05-11","age":"","mstatus":"","insh":"10000023795","cliId":"","pno":2074654922,"cno":"","email":"","ename":"","eno":"","pphy":"STEVENS, ROBERT B","ppno":2074652181,"pcpadd":"Oakland Family Medicine,9 Pleasant St","pcpcity":"Oakland","pcpstate":"ME","pcpzip":"04963","pcpcounty":"","pcpid":"","pcpname":"OAKLAND FAMILY MEDICINE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"153 E POND RD","madd2":"","madd3":"","mcity":"Oakland","mstate":"ME","mzip":"04963","pcpfaxno":2074654629,"pcpnpi":1407176175,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"2G75ED4TN75","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":[]},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I872","M7989","G4733","H1030","I517","I4819","I10","R944","H1033","Z0101","E119","R0602","E7800","Z7984","I4891","Z7901","I429","S81802D","L97229","I509","L97221","L97929","Z0000","E785","L0390","B9689","Z789","Z4800","I110","E669","Z6832","M9905","M9900","M9908","M9904","I2510","I2584","E8770","I5189","I519","I5023","I428","I4811","R918","R0600","I808","I82612","Z471","R600","M7662","L97928","M9901","L97829","Z96652","R0902","U071","I361","R079","I480","Z09","Z8739"],"date":["2024-08-08","2024-09-10","2024-05-20","2024-01-31","2025-10-06","2025-10-06","2024-02-14","2024-09-17","2024-01-31","2024-02-28","2024-12-19","2024-04-30","2023-03-16","2024-06-11","2024-06-11","2024-06-11","2024-05-08","2024-10-03","2024-09-05","2024-11-14","2024-09-19","2024-07-12","2022-12-28","2022-12-28","2024-07-12","2024-07-12","2024-04-30","2024-08-22","2024-05-07","2024-03-04","2024-03-04","2023-03-07","2023-03-07","2023-03-07","2023-03-07","2024-05-06","2024-05-06","2024-05-06","2024-04-30","2024-04-30","2024-05-07","2024-05-07","2024-05-07","2024-04-30","2024-04-30","2024-05-08","2024-05-08","2024-09-10","2024-09-10","2024-09-10","2024-09-26","2023-02-21","2024-08-08","2024-06-28","2024-02-14","2022-10-01","2022-09-28","2022-09-27","2022-09-30","2022-04-27","2022-04-27"],"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":[["","","ELIQUIS","","","Select","Select",""],["","","AMIODARONE HCL","","","Select","Select",""],["","","JARDIANCE","","","Select","Select",""],["","","SACUBITRIL-VALSARTAN","","","Select","Select",""],["","","ALLOPURINOL","","","Select","Select",""],["","","ENTRESTO","","","Select","Select",""],["","","METFORMIN HCL","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","PIOGLITAZONE HCL","","","Select","Select",""],["","","BUMETANIDE","","","Select","Select",""],["","","PACERONE","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","CARTIA XT","","","Select","Select",""],["","","METOPROLOL SUCCINATE","","","Select","Select",""],["","","COLCHICINE","","","Select","Select",""],["","","SULFAMETHOXAZOLE-TRIMETHOPRIM","","","Select","Select",""],["","","DOXYCYCLINE HYCLATE","","","Select","Select",""],["","","ONDANSETRON ODT","","","Select","Select",""],["","","AMOXICILLIN-CLAVULANATE POTASS","","","Select","Select",""],["","","TRAMADOL HCL","","","Select","Select",""],["","","METHYLPREDNISOLONE","","","Select","Select",""],["","","DILT-XR","","","Select","Select",""],["","","GLIMEPIRIDE","","","Select","Select",""],["","","METOPROLOL TARTRATE","","","Select","Select",""],["","","DILTIAZEM 24HR ER (CD)","","","Select","Select",""],["","","DILTIAZEM 24HR ER (XR)","","","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":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","",""],[],[""],[""],[""],[""],[""]],"comment":[["","","","",""],[],[""],[""],[""],[""],[""]],"sub":[]}}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["","1"],"comment":["",""],"sub":[]}},{"a":{"indx":["1",""],"comment":["",""],"sub":{"indx":[["","","","","",""],[],[""],[""],[""],[""],[""],[""],[""],[""],[""]],"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":""}]}]}