{"version":"0.4","data":[{"t":"Demographics","q":[{"name":"Steve A Campbell","gend":0,"currentgend":"","add":"5 CITY VIEW DRIVE","city":"Waterville","state":"ME","zip":"04901","dob":"1954-11-17","age":"","mstatus":"","insh":"10000070344","cliId":"","pno":2076496487,"cno":"","email":"camp7773@hotmail.com","ename":"","eno":"","pphy":"PHELPS, JULIE J","ppno":"","pcpadd":"Waterville Family Practice,31 Front St","pcpcity":"Waterville","pcpstate":"ME","pcpzip":"04901","pcpcounty":"","pcpid":"","pcpname":"WATERVILLE FAMILY PRACTICE","plan":"Martin's Point","program":"MEDICARE","lob":"GA - 2025","region":"","aligned":"","ano":"","add2":"","add3":"","madd1":"PO BOX 2524","madd2":"","madd3":"","mcity":"WATERVILLE","mstate":"ME","mzip":"04903","pcpfaxno":2078731186,"pcpnpi":1679562979,"currentgendcomment":"","pphycomment":"","uniqueid":"","medicareid":"4CK8HM6NX45","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":["I10","R7303","E559","Z0000","Z1389","Z139","Z125","E785","Z1331","I519","I447","E782","I2510","H25812","R931","I959","E119","E669","E8352","Z0100","Z23","R6889","I080","I501","N429","R011","E66811","R5383","E859","I110","I491","H25811","R7989","K760","M79675","Z0101","N179","A499","B957","R7881","J189","N390","R059","A411","J690","R509","R0989","N200","N400","Q438","R109","J9811","R590","R0602","R0902","I5020","A419","Z20822","I340","S90452A","W458XXA","M79672","M19072","M7732"],"date":["2025-09-18","2025-09-18","2025-09-18","2025-10-07","2025-10-07","2025-10-07","2024-09-11","2025-09-18","2025-10-07","2025-03-21","2025-03-05","2025-03-21","2025-03-21","2024-11-20","2024-11-18","2024-11-18","2024-12-23","2024-12-23","2022-12-22","2024-07-09","2025-10-07","2023-11-12","2024-11-15","2024-11-15","2023-08-14","2024-09-23","2024-12-23","2023-01-03","2023-08-14","2025-01-17","2025-03-05","2024-09-24","2022-10-26","2022-09-21","2022-08-09","2022-09-08","2022-06-10","2022-06-10","2022-06-10","2022-06-10","2022-05-26","2022-05-17","2022-05-26","2022-05-10","2022-05-10","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-03","2022-05-04","2022-05-03","2022-05-03","2022-05-04","2022-04-25","2022-04-25","2022-04-21","2022-04-21","2022-04-21"],"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":[["","","CARVEDILOL","","","Select","Select",""],["","","CHLORTHALIDONE","","","Select","Select",""],["","","ROSUVASTATIN CALCIUM","","","Select","Select",""],["","","LOSARTAN POTASSIUM","","","Select","Select",""],["","","AMLODIPINE BESYLATE","","","Select","Select",""],["","","PREDNISOLONE ACETATE","","","Select","Select",""],["","","SCOPOLAMINE","","","Select","Select",""],["","","FLUAD QUAD 2023-2024","","","Select","Select",""],["","","SPIKEVAX 2023-2024","","","Select","Select",""],["","","FLUAD QUAD 2022-2023","","","Select","Select",""],["","","SHINGRIX","","","Select","Select",""],["","","SIMVASTATIN","","","Select","Select",""],["","","MINOCYCLINE HCL","","","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":{"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":""}]}]}