{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Barnette W Brown","gend":0,"currentgend":"","add":"570 LEWISTON RD","city":"TOPSHAM","state":"ME","zip":"04086","dob":"1951-08-10","age":"","mstatus":"","insh":"10000066172","cliId":"","pno":2077981943,"cno":"","email":"","ename":"","eno":"","pphy":"HILARY, MANJU","ppno":2076573308,"pcpadd":"126 SHAKER RD,","pcpcity":"GRAY","pcpstate":"ME","pcpzip":"40399629","pcpcounty":"","pcpid":"","pcpname":"GRAY FAMILY HEALTH CENTER","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"570 LEWISTON RD","madd2":"","madd3":"","mcity":"TOPSHAM","mstate":"ME","mzip":"04086","pcpfaxno":2076573309,"pcpnpi":1710066410,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"7QE6X58QR84","medicaidid":"","pcpFlag":""},{"a":{"indx":["","","","","","","","1"],"comment":["","","","","","","",""],"sub":{"indx":[["No Ethnicity"]],"comment":[[""]],"sub":[]}}},{"a":[]},{"a":{"indx":["1",""],"comment":["",""],"sub":[]}},{"a":[]},{"a":[]}]},{"t":"Previously Documented Conditions","q":[{"a":{"diag":["I69354","C4442","R2681","I639","M25512","R531","I6529","R262","G250","I69359","M542","Z23","R251","Z8673","Z87891","I10","E039","R339","R42","M6281","M7989","R600","R6889","N400","R9089","R29818","M25611","M25612","R599","R202","R29898","I6521","R2232","R200","I5030","I358","I351","I63511","I69398","I63521","Z85828","G20","R2689","G43109","Z130","R252","I69954","Z8589","Z1211","R5383","I517","I77810","G9389","I69334","D649","I471","G8194","Q2112","R1310","I69393","Z736","M47812","M5020","M47811","M4802","H539","I6523","H547","H401132","I6930","R269","Z602","Z0389","H401131","E785","B1920","Z0000","Z0101"],"date":["2023-10-25","2023-08-02","2025-10-14","2025-10-14","2023-07-25","2025-04-10","2024-04-24","2023-08-25","2023-08-25","2024-07-10","2023-08-10","2024-11-26","2023-08-16","2025-01-10","2023-08-12","2024-11-26","2024-11-26","2023-02-10","2023-08-14","2023-08-15","2023-01-25","2024-12-27","2023-04-26","2023-08-21","2023-08-14","2023-01-25","2025-01-02","2025-01-02","2023-06-02","2023-08-12","2023-02-02","2024-04-24","2023-01-30","2023-08-12","2023-01-26","2024-12-27","2023-01-26","2023-02-13","2025-04-14","2023-08-25","2023-08-25","2023-08-25","2025-10-14","2023-08-02","2023-12-13","2025-04-14","2023-02-20","2023-02-20","2025-01-02","2025-04-10","2024-12-27","2024-12-27","2023-08-12","2023-02-02","2024-11-26","2023-02-20","2023-08-20","2023-08-16","2023-01-25","2023-08-20","2023-08-20","2023-01-26","2023-01-26","2023-01-26","2023-01-26","2023-06-19","2023-08-12","2023-01-25","2023-05-31","2023-08-14","2023-08-14","2023-08-14","2023-01-27","2022-11-17","2022-11-11","2022-11-11","2022-11-17","2022-11-17"],"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":[["","","CARBIDOPA-LEVODOPA","","","Select","Select",""],["","","LEVOTHYROXINE SODIUM","","","Select","Select",""],["","","CLOPIDOGREL","","","Select","Select",""],["","","ATORVASTATIN CALCIUM","","","Select","Select",""],["","","LISINOPRIL","","","Select","Select",""],["","","TAMSULOSIN HCL","","","Select","Select",""],["","","PREDNISONE","","","Select","Select",""],["","","ABRYSVO","","","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":""}]}]}